| NPI | 1992961908 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIETTA COTTINGHAM Program Director 757-896-1006 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: VA 1081) |
| Enumeration Date | 2008-07-30 |
| Last Update Date | 2008-07-30 |