| NPI | 1326476383 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RODNEY L JOHNSON CEO 910-321-0069 |
| Organization Subpart ? | No |
| Primary Taxonomy | 315P00000X Intermediate Care Facility, Intellectual Disabilities |
| Additional Taxonomies | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: NC MHL-063-105) |
| Enumeration Date | 2013-10-29 |
| Last Update Date | 2020-07-15 |