| NPI | 1033241005 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAULETTE L WASHINGTON Owner 704-712-8454 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: NC MHL-060-846) |
| Enumeration Date | 2007-03-12 |
| Last Update Date | 2008-06-24 |