| NPI | 1235781246 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANTOSH P GAUR Managing Member 919-844-6864 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Additional Taxonomies | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2019-07-10 |
| Last Update Date | 2019-11-26 |