| NPI | 1578742490 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CICLEY RENEE MALONE Facility Director 919-522-9674 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2007-10-26 |
| Last Update Date | 2007-12-27 |