| NPI | 1174898175 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONALD EDWARD BROWN Administor 919-949-6019 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: NC fcl032116) |
| Additional Taxonomies | 323P00000X Psychiatric Residential Treatment Facility (Licence: NC FCL032116) |
| Enumeration Date | 2012-03-09 |
| Last Update Date | 2012-03-09 |