| NPI | 1477365161 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHIRINNETTA N MUMFORD Operation Manager 336-337-5850 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2025-01-21 |
| Last Update Date | 2025-06-09 |