| NPI | 1326568239 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHANTAY D PARKER Owner 336-324-8008 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: NC 041-1146) |
| Enumeration Date | 2017-06-21 |
| Last Update Date | 2022-07-21 |