| NPI | 1598381378 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TYJEAN MOORE CEO/Therapist 336-653-0168 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2020-06-17 |
| Last Update Date | 2020-06-17 |