NPI | 1093066714 |
---|---|
Entity Type | Organization |
Authorized Contact | JACK MARCELLOUS PHILLIPS Executive Director/CEO 704-392-9220 |
Organization Subpart ? | No |
Primary Taxonomy | 315P00000X Intermediate Care Facility, Intellectual Disabilities (Licence: NC MHL-060-118) |
Enumeration Date | 2012-09-20 |
Last Update Date | 2012-09-20 |