| NPI | 1972875318 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTINA SMITH JACKSON Records Manager/Co Owner 434-610-6132 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: VA 1751) |
| Enumeration Date | 2012-02-01 |
| Last Update Date | 2012-02-01 |