| NPI | 1255173258 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATALIA GONZALEZ Owner 336-417-3751 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| 310400000X Assisted Living Facility | |
| 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness | |
| 3104A0630X Assisted Living Facility, Assisted Living, Behavioral Disturbances | |
| 310500000X Intermediate Care Facility, Mental Illness | |
| 311ZA0620X Custodial Care Facility, Adult Care Home | |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| 385H00000X Respite Care | |
| Enumeration Date | 2024-06-10 |
| Last Update Date | 2024-06-10 |