| NPI | 1649827296 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FANTA DORLEY CFO 336-662-7284 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA0600X Clinic/Center Adult Day Care |
| Additional Taxonomies | 174200000X Meals |
| 251B00000X Case Management | |
| 251C00000X Day Training, Developmentally Disabled Services | |
| 261QM1300X Clinic/Center Multi-Specialty | |
| 343900000X Non-emergency Medical Transport (VAN) | |
| 347C00000X Private Vehicle | |
| Enumeration Date | 2019-08-19 |
| Last Update Date | 2019-08-19 |