| NPI | 1558736066 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIC M. PAGE Operations Manager 336-272-8335 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2015-12-09 |
| Last Update Date | 2016-03-08 |