| NPI | 1265758916 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ZELMA JACKSON- WOLFE Executive Director 336-749-7660 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: NC MHL 034-254) |
| Additional Taxonomies | 253Z00000X In Home Supportive Care |
| Enumeration Date | 2010-04-20 |
| Last Update Date | 2023-07-25 |