| NPI | 1700205705 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHIRLEY A. MCMILLION-JACKSON Owner 251-423-8197 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2014-04-08 |
| Last Update Date | 2014-05-05 |