| NPI | 1609058403 |
|---|---|
| Doing Business As | GROUP HOME |
| Entity Type | Organization |
| Authorized Contact | CYNTHIA TERESA HENDERSON Owner 919-479-5073 |
| Organization Subpart ? | No |
| Primary Taxonomy | 385HR2060X Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child |
| Enumeration Date | 2007-12-04 |
| Last Update Date | 2007-12-04 |