| NPI | 1528214905 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZABETH VICTORIA CALDWELL Owner 910-489-9036 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2008-08-17 |
| Last Update Date | 2010-03-01 |