| NPI | 1912266396 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMIKA RENEE GROVES Chief Executive Officer 804-301-5920 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: NC MHL-074-238) |
| Enumeration Date | 2012-05-07 |
| Last Update Date | 2012-05-07 |