| NPI | 1013152578 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TARSHA VIOLET HOWARD Director 336-254-3137 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: NC MHL-041-882) |
| Enumeration Date | 2008-12-11 |
| Last Update Date | 2008-12-11 |