| NPI | 1407003767 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHANDRA REVIS PEGUES Director & CEO 252-363-4122 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: NC MHL-098-122) |
| Additional Taxonomies | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: NC MHL-098-122) |
| Enumeration Date | 2008-08-19 |
| Last Update Date | 2008-08-19 |