| NPI | 1922489491 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IRENE DAVIS Administrator 804-861-1353 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311Z00000X Custodial Care Facility (Licence: VA ADC141103624) |
| Additional Taxonomies | 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness (Licence: VA ALF141103821) |
| Enumeration Date | 2015-06-10 |
| Last Update Date | 2015-06-10 |