| NPI | 1619093895 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KARA MCCANN Director Of Program Supports 336-883-0650 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: NC MHL-041-565) |
| Enumeration Date | 2007-03-21 |
| Last Update Date | 2008-06-25 |