| NPI | 1306995204 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIE INGRAM Director 919-806-7603 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: NC 032-372) |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2008-08-11 |