| NPI | 1235249285 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REGINA FERGUSON Executive Director 336-855-1810 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| 322D00000X Residential Treatment Facility, Emotionally Disturbed Children | |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2020-08-22 |