| NPI | 1013062413 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENNIS BRADSHAW Executive Director 919-942-7391 |
| Organization Subpart ? | No |
| Primary Taxonomy | 315P00000X Intermediate Care Facility, Intellectual Disabilities |
| Enumeration Date | 2007-01-24 |
| Last Update Date | 2020-08-22 |