| NPI | 1124132030 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAWN L MCCULLEN Director 910-265-1756 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| Additional Taxonomies | 251B00000X Case Management |
| 251S00000X Community/Behavioral Health | |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2012-11-21 |