| NPI | 1568554293 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDY ANDERSON President 910-642-5697 |
| Organization Subpart ? | No |
| Primary Taxonomy | 315P00000X Intermediate Care Facility, Mentally Retarded (Licence: NC MHL041070) |
| Enumeration Date | 2006-09-29 |
| Last Update Date | 2020-08-22 |