| NPI | 1710005517 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM HARRIS Director Owner 910-554-1355 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: NC MHL-067-143) |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2020-08-22 |