| NPI | 1962286120 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RENARD LAVELL COX Director 804-617-0969 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| Additional Taxonomies | 251C00000X Day Training, Developmentally Disabled Services |
| Enumeration Date | 2023-08-21 |
| Last Update Date | 2023-09-25 |