| NPI | 1114179512 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADELE M NEWMAN Director 336-578-0904 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: NC MHL001-167) |
| Enumeration Date | 2008-10-16 |
| Last Update Date | 2008-10-16 |