| NPI | 1518746510 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VALORIE ENOCH Co Owner 336-687-3759 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 251C00000X Day Training, Developmentally Disabled Services |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| 385HR2060X Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child | |
| 261QD1600X Clinic/Center, Developmental Disabilities | |
| 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| Enumeration Date | 2023-09-27 |
| Last Update Date | 2023-11-26 |