| NPI | 1437203890 |
|---|---|
| Doing Business As | LIFE/RAVEN RIDGE GROUP HOME |
| Entity Type | Organization |
| Authorized Contact | RICHARD LYNN SMITH VP Of Business Operations 919-778-1900 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 315P00000X Intermediate Care Facility, Mentally Retarded (Licence: NC MHL-098-011) |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2017-12-15 |