NPI | 1568792802 |
---|---|
Entity Type | Organization |
Authorized Contact | LARRY LEE LACKEY Executive Director 919-414-2860 |
Organization Subpart ? | No |
Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
Additional Taxonomies | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: NC MHL-096-225) |
Enumeration Date | 2010-01-09 |
Last Update Date | 2017-07-07 |