| NPI | 1386730190 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALICE DELORIS SMITH Executive Director 910-484-1869 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities (Licence: NC MHL-026-276) |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2020-08-22 |