| NPI | 1477737112 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSE JAMES BANKS Financial Administration 919-427-1402 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: NC MHL-032-418) |
| Additional Taxonomies | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: NC MHL-032-418) |
| Enumeration Date | 2007-12-17 |
| Last Update Date | 2008-01-12 |