| NPI | 1417462342 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SIGNAL WHITE Director 336-406-9959 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: NC MHL-001-252) |
| Enumeration Date | 2017-12-14 |
| Last Update Date | 2018-03-17 |