| NPI | 1487745048 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARTINA EKWUTOSI UKATTAH Administrator 336-294-4966 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: NC mhl-041-767) |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2020-08-22 |