| NPI | 1598894842 |
|---|---|
| Doing Business As | OUR HOME |
| Entity Type | Organization |
| Authorized Contact | ELLEN ROGERS BLACK Administrator 336-987-0572 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: NC MHL -041-669) |
| Enumeration Date | 2007-03-04 |
| Last Update Date | 2008-07-07 |