| NPI | 1669736252 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAVEN JANEEN BARNES Owner/Director 252-281-1048 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: NC MHL-098-179) |
| Enumeration Date | 2012-06-27 |
| Last Update Date | 2012-06-27 |