| NPI | 1386956183 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY MICHELLE FOUST Owner 336-213-5830 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities (Licence: NC MHL-001-196) |
| Enumeration Date | 2010-07-08 |
| Last Update Date | 2010-07-08 |