| NPI | 1164574471 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VERTHA L LEACH Director 336-454-5295 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251B00000X Case Management |
| Additional Taxonomies | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: NC MHL-041-755) |
| Enumeration Date | 2007-01-17 |
| Last Update Date | 2020-08-22 |