| NPI | 1346571304 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBIN BLACKWELL Director 336-317-1926 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2010-01-14 |
| Last Update Date | 2022-07-21 |