| NPI | 1619015112 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FREDERICK LEON DUNSTON Co Owner 919-602-3455 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: NC MHL-032-343) |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2020-08-22 |