| NPI | 1942533849 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MORY BAMBA CEO 804-651-6890 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: VA 1167-01-001) |
| Enumeration Date | 2009-09-09 |
| Last Update Date | 2009-09-09 |