| NPI | 1417146531 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SIBILLIA GRAVES Owner 336-656-7767 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: NC MHL041613) |
| Enumeration Date | 2007-10-15 |
| Last Update Date | 2009-02-16 |