| NPI | 1275808990 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | QUENZELL THOMAS Owner 910-690-3371 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 251B00000X Case Management |
| Enumeration Date | 2012-03-13 |
| Last Update Date | 2012-03-13 |