| NPI | 1649073065 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEIRDRE D VINSON Member/Organizer 336-512-9568 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2025-03-31 |
| Last Update Date | 2025-04-01 |