| NPI | 1063682573 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BEVERLY J JENKINS Director 919-620-1416 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities (Licence: NC MHL032426) |
| Enumeration Date | 2008-03-11 |
| Last Update Date | 2008-03-11 |