| NPI | 1083127997 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOMINICK EARL MITCHELL Asst Program Manager 336-268-7089 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251C00000X Day Training, Developmentally Disabled Services |
| Enumeration Date | 2017-11-14 |
| Last Update Date | 2017-11-14 |