| NPI | 1023272663 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ZELMA JACKSON WOLFE Administrator 336-722-8354 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| Enumeration Date | 2008-07-14 |
| Last Update Date | 2008-07-14 |