| NPI | 1134555311 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VIVIAN HAITH TIMMONS CEO 336-512-2114 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities (Licence: NC MHL-001-148) |
| Enumeration Date | 2013-09-19 |
| Last Update Date | 2013-09-19 |