| NPI | 1285440438 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DESIREE DICKERSON Chief Executive Officer 980-275-3707 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 310400000X Assisted Living Facility |
| 385H00000X Respite Care | |
| 3104A0630X Assisted Living Facility, Assisted Living, Behavioral Disturbances | |
| 385HR2060X Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child | |
| 261QD1600X Clinic/Center, Developmental Disabilities | |
| Enumeration Date | 2024-12-03 |
| Last Update Date | 2025-10-13 |