| NPI | 1164736138 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMELIA S MCNEILL Executive Director 910-805-7802 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251C00000X |
| Additional Taxonomies | 251B00000X Case Management |
| 251S00000X Community/Behavioral Health | |
| 252Y00000X Early Intervention Provider Agency | |
| 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| Enumeration Date | 2010-08-02 |
| Last Update Date | 2010-08-02 |