| NPI | 1063260016 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CYSHELLE GRAHAM CEO 910-699-3030 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 310400000X Assisted Living Facility |
| 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness | |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| 343900000X Non-emergency Medical Transport (VAN) | |
| 347C00000X Private Vehicle | |
| Enumeration Date | 2024-05-07 |
| Last Update Date | 2024-05-07 |