| NPI | 1972137651 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CONSTANCE DIANE ROGERS CEO Owner 757-268-5975 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2020-03-02 |
| Last Update Date | 2020-03-02 |