| NPI | 1053047365 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SA'D THOMPSON Owner 919-972-9004 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 311ZA0620X Custodial Care Facility, Adult Care Home |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| Enumeration Date | 2022-07-28 |
| Last Update Date | 2022-07-28 |