| NPI | 1689201451 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WALTER YOUNG Executive Director 980-886-6680 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| Additional Taxonomies | 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| Enumeration Date | 2020-03-23 |
| Last Update Date | 2020-12-09 |