| NPI | 1134245293 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK W. GOODWIN Executive Director 336-751-3276 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities (Licence: NC MHL-030-026) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| 253Z00000X In Home Supportive Care | |
| 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | |
| 385H00000X Respite Care | |
| Enumeration Date | 2007-03-21 |
| Last Update Date | 2017-10-11 |