| NPI | 1154471811 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMMY BALDWIN Director 910-944-7500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251X00000X Supports Brokerage |
| Additional Taxonomies | 251B00000X Case Management |
| 251C00000X | |
| 251S00000X Community/Behavioral Health | |
| 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| Enumeration Date | 2007-01-12 |
| Last Update Date | 2011-04-27 |