| NPI | 1104127885 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANDRA JONES ROSS Owner/Operations Manager 919-801-4247 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2010-11-10 |
| Last Update Date | 2011-02-14 |