| NPI | 1588780142 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NADINE WILLIAMS Program Manager 919-806-9528 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities (Licence: NC MHL032228) |
| Additional Taxonomies | 251B00000X Case Management (Licence: NC MHL032228) |
| 251S00000X Community/Behavioral Health (Licence: NC MHL032228) | |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2020-08-22 |