| NPI | 1174190714 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CANDICE STATON SCALES Office Manager 336-554-1625 |
| Organization Subpart ? | No |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency |
| Additional Taxonomies | 174200000X Meals |
| 251300000X Local Education Agency (LEA) | |
| 251S00000X Community/Behavioral Health | |
| 251V00000X Voluntary or Charitable | |
| Enumeration Date | 2021-06-10 |
| Last Update Date | 2021-10-18 |