| NPI | 1700429230 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NORMA BURTON Administrator 336-437-4167 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320700000X Residential Treatment Facility, Physical Disabilities |
| Enumeration Date | 2019-10-28 |
| Last Update Date | 2019-10-28 |