| NPI | 1104176338 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL HACKMANN CEO 919-734-7398 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 315P00000X Intermediate Care Facility, Intellectual Disabilities (Licence: NC MHL-098-005) |
| Additional Taxonomies | 313M00000X Nursing Facility/Intermediate Care Facility (Licence: NC MHL-098-005) |
| Enumeration Date | 2012-09-14 |
| Last Update Date | 2019-01-18 |