| NPI | 1962637678 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DARYL A JEFFERSON CEO/Owner 804-523-7702 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2009-05-26 |
| Last Update Date | 2009-05-26 |