| NPI | 1952751117 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICKY POTTS Director 757-240-4180 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: VA 1214-08-011) |
| Enumeration Date | 2016-06-20 |
| Last Update Date | 2016-06-20 |