| NPI | 1972385060 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRAVIS FLETCHER CEO/Owner 804-677-2561 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2023-10-16 |
| Last Update Date | 2023-10-16 |