| NPI | 1578840567 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATANYA DAVIS Executive Director 252-409-0080 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: NC MHL-098-166) |
| Enumeration Date | 2011-11-04 |
| Last Update Date | 2011-11-04 |