| NPI | 1932279072 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VANESSA LANE Director, Cycle Mngt./Accounts Rece 540-542-0200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility (Licence: VA 232) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: WV 425) |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2017-09-20 |