| NPI | 1326273111 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLARISSA PAUL Admin 336-790-0277 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness | |
| 311ZA0620X Custodial Care Facility, Adult Care Home | |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| 385H00000X Respite Care | |
| 385HR2060X Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child | |
| Enumeration Date | 2009-05-21 |
| Last Update Date | 2023-08-22 |