| NPI | 1962002279 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TYRONZA COLEMAN President 434-272-9342 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Additional Taxonomies | 343900000X Non-emergency Medical Transport (VAN) |
| 310400000X Assisted Living Facility | |
| 311Z00000X Custodial Care Facility | |
| Enumeration Date | 2020-10-27 |
| Last Update Date | 2020-10-27 |