| NPI | 1528173069 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSHUA DENNY Executive Director/Qidp 336-719-0062 |
| Organization Subpart ? | No |
| Primary Taxonomy | 315P00000X Intermediate Care Facility, Intellectual Disabilities (Licence: NC MHL-086-019) |
| Enumeration Date | 2006-08-21 |
| Last Update Date | 2018-06-08 |