| NPI | 1659614790 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RODNEY ANTONIO EDWARDS Director/Qp 336-862-5013 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: NC 16235) |
| Enumeration Date | 2013-03-27 |
| Last Update Date | 2013-03-27 |