| NPI | 1972121457 |
|---|---|
| Former Legal Business Name | GROUP HOME |
| Entity Type | Organization |
| Authorized Contact | LAVON SEAN WRIGHT Owner 804-909-6030 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251E00000X Home Health |
| Enumeration Date | 2020-07-10 |
| Last Update Date | 2020-07-10 |