| NPI | 1467022038 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CEAEIRA WHITE Owner 336-858-5981 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 251C00000X |
| 253Z00000X In Home Supportive Care | |
| 310500000X Intermediate Care Facility, Mental Illness | |
| 315P00000X Intermediate Care Facility, Intellectual Disabilities | |
| 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| Enumeration Date | 2021-06-28 |
| Last Update Date | 2021-09-10 |