| NPI | 1962688341 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICTOR M MOODY Vice President 757-224-7986 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2008-01-15 |
| Last Update Date | 2008-01-15 |