| NPI | 1578897450 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROSALINA TEEL Owner 910-385-8232 |
| Organization Subpart ? | No |
| Primary Taxonomy | 315P00000X Intermediate Care Facility, Intellectual Disabilities |
| Enumeration Date | 2009-09-25 |
| Last Update Date | 2009-09-25 |