| NPI | 1427239979 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAVONDA C MEACHEM Director Owner 336-707-6517 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: NC MHL041816) |
| Enumeration Date | 2007-11-26 |
| Last Update Date | 2008-07-14 |