| NPI | 1578394979 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIESHQUANNA RICHARDSON Admin 919-664-2155 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Additional Taxonomies | 311Z00000X Custodial Care Facility |
| 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| 343900000X Non-emergency Medical Transport (VAN) | |
| 347C00000X Private Vehicle | |
| Enumeration Date | 2024-08-08 |
| Last Update Date | 2024-08-08 |