| NPI | 1366563777 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAWN L MCCULLEN President 910-265-1756 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: NC MHL067034) |
| Additional Taxonomies | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: NC MHL067100) |
| Enumeration Date | 2007-04-03 |
| Last Update Date | 2013-02-22 |