| NPI | 1265013734 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY JOHNS BENSON Director Of Billing 336-553-5946 |
| Organization Subpart ? | No |
| Primary Taxonomy | 315P00000X Intermediate Care Facility, Intellectual Disabilities |
| Enumeration Date | 2021-04-16 |
| Last Update Date | 2021-04-16 |