| NPI | 1366773723 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBBIE DICKENS TELFAIR Owner 252-641-0361 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: NC mhl064110) |
| Enumeration Date | 2010-01-26 |
| Last Update Date | 2010-01-26 |