| NPI | 1043010945 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HANIA MAE LITAKER Health Administrator 919-888-0654 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 311ZA0620X Custodial Care Facility, Adult Care Home |
| 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children | |
| Enumeration Date | 2025-03-18 |
| Last Update Date | 2025-03-18 |