NPI | 1063788040 |
---|---|
Entity Type | Organization |
Authorized Contact | SHANITTA RENEE BROOKS Owner/Administrator 252-969-1934 |
Organization Subpart ? | No |
Primary Taxonomy | 320700000X Residential Treatment Facility, Physical Disabilities |
Additional Taxonomies | 174H00000X Health Educator |
320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
320800000X Community Based Residential Treatment Facility, Mental Illness | |
385H00000X Respite Care | |
Enumeration Date | 2012-03-23 |
Last Update Date | 2012-03-23 |