| NPI | 1093021115 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BEN JOHNSON Director Of Ops 919-450-5640 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: NC MHL032544) |
| Enumeration Date | 2010-08-26 |
| Last Update Date | 2010-08-26 |