| NPI | 1194807552 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUDY P. ROSSER Executive Director 336-751-5014 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: NC MHL-030-021) |
| Enumeration Date | 2006-10-19 |
| Last Update Date | 2020-08-22 |