| NPI | 1679310510 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAIKIEMA EVANS MIS S 336-523-6726 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| Enumeration Date | 2024-07-09 |
| Last Update Date | 2024-07-15 |