NPI | 1083128508 |
---|---|
Entity Type | Organization |
Authorized Contact | ALPHONSUS E NGWADOM Administrator 919-247-2312 |
Organization Subpart ? | No |
Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
310400000X Assisted Living Facility | |
3104A0625X Assisted Living Facility, Assisted Living, Mental Illness | |
315P00000X Intermediate Care Facility, Intellectual Disabilities | |
320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
376G00000X Nursing Home Administrator | |
Enumeration Date | 2017-11-20 |
Last Update Date | 2023-04-02 |