| NPI | 1275338998 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOMINIQUE RAYSHAWN WILLIAMS CEO 336-255-4473 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| 322D00000X Residential Treatment Facility, Emotionally Disturbed Children | |
| Enumeration Date | 2025-02-17 |
| Last Update Date | 2025-02-25 |