| NPI | 1053636290 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMELIA BENNETT Director 910-425-1445 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 251B00000X Case Management |
| 251B00000X Case Management | |
| 385HR2060X Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child | |
| Enumeration Date | 2010-03-31 |
| Last Update Date | 2010-03-31 |