| NPI | 1023444833 |
|---|---|
| Other Name | DAY PROGRAM |
| Entity Type | Organization |
| Authorized Contact | DAVID W FORSYTHE Executive Director 336-599-9421 |
| Organization Subpart ? | No |
| Primary Taxonomy | 315P00000X Intermediate Care Facility, Intellectual Disabilities |
| Additional Taxonomies | 251C00000X Day Training, Developmentally Disabled Services |
| 251S00000X | |
| Enumeration Date | 2013-09-25 |
| Last Update Date | 2013-09-25 |