| NPI | 1275684664 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EVELYN LUCINDA WHITLEY Adminitrator 919-735-2158 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: NC MHL096148) |
| Additional Taxonomies | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: NC MHL096119) |
| Enumeration Date | 2007-01-14 |
| Last Update Date | 2020-08-22 |