| NPI | 1053453258 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONALD LEON HOOVER Idd Services Coordinator 910-763-3424 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 251C00000X Day Training, Developmentally Disabled Services (Licence: NC MHL-065-099) |
| Enumeration Date | 2007-02-13 |
| Last Update Date | 2019-03-07 |