| NPI | 1699897504 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROLYN W MCMANUS Administrative Director 336-379-7670 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities |
| Enumeration Date | 2007-04-04 |
| Last Update Date | 2020-08-22 |