| NPI | 1154647147 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THERESA H WINSTEAD Owner 336-599-4936 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2010-04-15 |
| Last Update Date | 2010-04-15 |