| NPI | 1265572879 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TONJA MCLEAN REID Owner 910-723-0532 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 103T00000X Psychologist |
| 104100000X Social Worker | |
| 1041C0700X Social Worker, Clinical | |
| 251C00000X Day Training, Developmentally Disabled Services | |
| 252Y00000X Early Intervention Provider Agency | |
| 261QD1600X Clinic/Center, Developmental Disabilities | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) | |
| 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 | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| 385H00000X Respite Care | |
| 385HR2060X Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child | |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2023-06-13 |