| NPI | 1134393994 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEARLDINE N MOORE President 336-659-0880 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: NC MHL034225) |
| Enumeration Date | 2008-04-14 |
| Last Update Date | 2008-04-14 |