NPI | 1114073814 |
---|---|
Entity Type | Organization |
Authorized Contact | PENNY S CHISHOLM Director 336-887-2402 |
Organization Subpart ? | No |
Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
Additional Taxonomies | 251S00000X |
Enumeration Date | 2007-01-26 |
Last Update Date | 2020-08-22 |