| NPI | 1043365091 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEARLDINE N. MOORE President 336-659-0880 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2012-12-18 |