| NPI | 1578794616 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANY LEDBETTER Owner/Operator 336-884-5544 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities (Licence: NC MHL-041-921) |
| Enumeration Date | 2009-08-06 |
| Last Update Date | 2009-08-06 |