| NPI | 1982677027 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HARRY LEGROS Executive Director 804-733-9140 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: VA 523-01) |
| Enumeration Date | 2006-02-09 |
| Last Update Date | 2020-08-22 |