| NPI | 1104651124 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATHANIEL PETERKIN Principal 336-292-2923 |
| Organization Subpart ? | No |
| Primary Taxonomy | 385HR2055X Respite Care, Respite Care, Mental Illness, Child |
| Additional Taxonomies | 251B00000X Case Management |
| 251S00000X | |
| Enumeration Date | 2024-09-09 |
| Last Update Date | 2024-09-09 |