| NPI | 1013107143 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOAN MARIE WHITE CEO & Executive Director 336-784-5922 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Additional Taxonomies | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2007-07-25 |
| Last Update Date | 2020-08-22 |