| NPI | 1508003443 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEMETRIUS RAYSHAUN THOMPSON Executive Director 252-454-0011 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: NC MHL-064-097) |
| Enumeration Date | 2009-01-14 |
| Last Update Date | 2009-01-14 |