| NPI | 1093017238 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIE MORRIS Administrator 252-469-5264 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities (Licence: NC MHL033090) |
| Enumeration Date | 2010-11-19 |
| Last Update Date | 2010-11-19 |