| NPI | 1336676030 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANA GOLDSMITH Owner 336-624-4370 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2017-05-12 |
| Last Update Date | 2017-05-12 |