| NPI | 1083056782 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SERA GILMORE Administrator 910-484-3717 |
| Organization Subpart ? | No |
| Primary Taxonomy | 315P00000X Intermediate Care Facility, Mentally Retarded (Licence: NC MHL-026-944) |
| Enumeration Date | 2013-07-23 |
| Last Update Date | 2015-12-07 |