| NPI | 1669640967 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAMONTE DEWAYNE DUNLAP Owner 336-587-1678 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 385HR2060X Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child |
| Enumeration Date | 2008-02-20 |
| Last Update Date | 2008-06-13 |