| NPI | 1588714604 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JERALD HOWELL CEO 919-778-1506 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: NC MHL-054-096) |
| Enumeration Date | 2007-01-11 |
| Last Update Date | 2012-11-28 |