| NPI | 1497229173 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COURTNEY SIMS Executive Director 251-259-0857 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2019-01-16 |
| Last Update Date | 2024-03-25 |