| NPI | 1063549103 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROL PARKER Executive Director 251-456-7100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: AL 119223) |
| Enumeration Date | 2007-02-27 |
| Last Update Date | 2020-08-22 |