| NPI | 1376737361 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JIMMIE HILL C Eo 252-745-5761 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: NC MHL069006) |
| Additional Taxonomies | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: NC MHL069006) |
| 385H00000X Respite Care (Licence: NC MHL069006) | |
| Enumeration Date | 2007-09-01 |
| Last Update Date | 2020-10-15 |