| NPI | 1720274509 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SOPHIA BLANKS PIERCE Executive Director 910-488-8477 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: NC MHL-026-299) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: NC MHL026299) | |
| Enumeration Date | 2007-09-14 |
| Last Update Date | 2018-12-03 |