| NPI | 1598046013 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHERRILL KAYE DAVIS Director 336-218-1176 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: NC MHL041929) |
| Additional Taxonomies | 251S00000X |
| 253Z00000X In Home Supportive Care | |
| Enumeration Date | 2011-08-30 |
| Last Update Date | 2022-02-14 |