| NPI | 1265032320 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DESHON WISE Qualified Professional 919-671-1989 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3104A0625X Assisted Living Facility Assisted Living, Mental Illness |
| Enumeration Date | 2020-10-28 |
| Last Update Date | 2020-10-30 |