| NPI | 1518153683 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALVETH JOYCE YOUNG Co Owner 919-957-7985 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: NC MHL-032-415) |
| Additional Taxonomies | 315P00000X Intermediate Care Facility, Intellectual Disabilities |
| 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: NC MHL-032-415) | |
| 347C00000X Private Vehicle (Licence: NC MHL-032-415) | |
| Enumeration Date | 2007-09-21 |
| Last Update Date | 2007-10-27 |