| NPI | 1215024682 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES ROBERT PAUL Director 336-760-5516 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2006-10-06 |
| Last Update Date | 2008-06-10 |