| NPI | 1629118013 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN ERIC WATERS Secretary Treasurer 252-566-3600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: NC MHL-054-124) |
| Enumeration Date | 2007-02-07 |
| Last Update Date | 2020-08-22 |