| NPI | 1649939265 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHERYL MATHEWS Deputy Director 910-488-8477 |
| Organization Subpart ? | No |
| Primary Taxonomy | 315P00000X Intermediate Care Facility, Intellectual Disabilities |
| Enumeration Date | 2021-12-10 |
| Last Update Date | 2021-12-10 |