| NPI | 1023273505 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES HOWARD SAMMONS Owner 919-217-0112 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: NC MHL-092-470) |
| Enumeration Date | 2008-07-23 |
| Last Update Date | 2008-07-23 |