| NPI | 1215356209 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNON HAIRSTON Owner/Director 336-456-5022 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: NC MHL-041-926) |
| Enumeration Date | 2014-04-07 |
| Last Update Date | 2016-10-03 |