| NPI | 1154402303 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEISHA RENEE GILL Owner/Qualified Professional 910-875-1482 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 251B00000X Case Management |
| 251S00000X Community/Behavioral Health | |
| 251C00000X Day Training, Developmentally Disabled Services | |
| 251X00000X Supports Brokerage | |
| 251G00000X Hospice Care, Community Based | |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| 322D00000X Residential Treatment Facility, Emotionally Disturbed Children | |
| 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| 3747P1801X Technician, Personal Care Attendant | |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2010-08-31 |