| NPI | 1346116456 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN LEE PERRY Member/Manager 336-729-5927 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2025-10-15 |
| Last Update Date | 2025-10-15 |