| NPI | 1063390458 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KALYNN BLOW Executive Director 252-814-0908 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| Additional Taxonomies | 251C00000X Day Training, Developmentally Disabled Services |
| 251E00000X Home Health | |
| 251S00000X Community/Behavioral Health | |
| 261QA0005X Clinic/Center Ambulatory Family Planning Facility | |
| 385H00000X Respite Care | |
| 385HR2050X Respite Care Respite Care Camp | |
| 385HR2065X Respite Care Respite Care, Physical Disabilities, Child | |
| Enumeration Date | 2025-08-25 |
| Last Update Date | 2025-08-25 |