| NPI | 1629213962 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSIE HOWELL Billing Specialist 919-778-1506 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities (Licence: NC MHL096099) |
| Enumeration Date | 2008-12-15 |
| Last Update Date | 2008-12-15 |