| NPI | 1932534864 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMONE OCTAVIUS BANKS CEO 804-895-0510 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: VA 2413) |
| Enumeration Date | 2013-09-11 |
| Last Update Date | 2023-02-13 |