| NPI | 1235459389 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIKA HELENE HENDRIX Director 336-587-8876 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: NC MHL-041-959) |
| Enumeration Date | 2010-06-10 |
| Last Update Date | 2023-09-15 |