| NPI | 1588279442 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIWANA HORNE CEO 252-245-6035 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2020-09-08 |
| Last Update Date | 2020-09-08 |