| NPI | 1093991234 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANITA LOVELACE Director/ Owner 336-767-4540 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 311ZA0620X Custodial Care Facility, Adult Care Home |
| 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: NC 034-224) | |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| Enumeration Date | 2008-01-17 |
| Last Update Date | 2019-11-18 |