| NPI | 1366594715 |
|---|---|
| Former Legal Business Name | COLTRANES GROUP HOME INC |
| Entity Type | Organization |
| Authorized Contact | LATHAY LORRAINE COLTRANE Owner 336-299-9757 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| Enumeration Date | 2007-01-17 |
| Last Update Date | 2008-04-25 |