| NPI | 1689742751 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON TREMAIN BARNETT Executive Director 252-714-1230 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: NC MHL-074-136) |
| Enumeration Date | 2006-11-30 |
| Last Update Date | 2018-03-17 |