| NPI | 1215106331 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AKILIA SLOCUMB Administrator 910-904-0297 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 251B00000X Case Management |
| 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: NC MHL-047-115) | |
| Enumeration Date | 2008-02-22 |
| Last Update Date | 2015-05-08 |