| NPI | 1679797443 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANNAE LYNN WHITE Cepo 336-274-1492 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: NC MHL-041-700) |
| Enumeration Date | 2007-04-12 |
| Last Update Date | 2008-01-02 |