| NPI | 1518343458 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBIN BLACKWELL Owner 336-317-1926 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Additional Taxonomies | 253Z00000X In Home Supportive Care |
| 251S00000X | |
| Enumeration Date | 2015-08-03 |
| Last Update Date | 2015-08-05 |