| NPI | 1912062860 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES PETERSON President 757-399-1924 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: VA 010027667) |
| Enumeration Date | 2006-12-22 |
| Last Update Date | 2020-08-22 |