| NPI | 1053987065 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MISHA M SYKES Co Owner 919-583-7288 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2021-06-01 |
| Last Update Date | 2021-06-01 |