| NPI | 1396042057 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANICE TIMPSON Owner 336-432-1861 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: NC MHL-041-988) |
| Enumeration Date | 2011-02-16 |
| Last Update Date | 2011-02-16 |