| NPI | 1962653436 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAREY L LOMAX CEO 757-965-4899 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities (Licence: VA 593-03-011) |
| Additional Taxonomies | 385H00000X Respite Care (Licence: VA 593-03-011) |
| Enumeration Date | 2008-10-02 |
| Last Update Date | 2018-07-09 |