| NPI | 1073690046 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SONIA DORINE WARD Director 919-345-0045 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities (Licence: NC MHL-092-563) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2020-08-22 |