| NPI | 1952601866 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRYSTAL M LARIOS L PT A 757-842-2437 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: VA 2306602413) |
| Enumeration Date | 2010-10-26 |
| Last Update Date | 2010-10-26 |