| NPI | 1497891832 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID W FORSYTHE Executive Director 336-599-9421 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251B00000X Case Management |
| Additional Taxonomies | 251C00000X |
| 251S00000X Community/Behavioral Health | |
| 251T00000X PACE Provider Organization | |
| 251X00000X Supports Brokerage | |
| 310400000X Assisted Living Facility | |
| 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| 320700000X Residential Treatment Facility, Physical Disabilities | |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| 343800000X Secured Medical Transport (VAN) | |
| 343900000X Non-emergency Medical Transport (VAN) | |
| 347C00000X Private Vehicle | |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2020-08-22 |