| NPI | 1083745756 |
|---|---|
| Doing Business As | OUR HOME - AUNT ZOLA'S |
| Entity Type | Organization |
| Authorized Contact | ELLEN ROGERS BLACK Administrator 336-987-0572 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: NC MHL 041-781) |
| Enumeration Date | 2007-03-07 |
| Last Update Date | 2008-07-07 |