| NPI | 1063910552 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALTHELDA CAMPBELL STALLWORTH Executive Director 251-209-1894 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2018-01-30 |
| Last Update Date | 2018-01-30 |