| NPI | 1144422452 |
|---|---|
| Doing Business As | NONE |
| Entity Type | Organization |
| Authorized Contact | ALONZO YATES Owner 919-680-4637 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities (Licence: NC MHL032371) |
| Enumeration Date | 2007-05-31 |
| Last Update Date | 2020-08-22 |