| NPI | 1720420177 |
|---|---|
| Other Name | DEPARTURE DRIVE TOTAL LIFE CENTER |
| Entity Type | Organization |
| Authorized Contact | DAVID COTTENGIM President 919-713-1521 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA0600X Clinic/Center Adult Day Care |
| Enumeration Date | 2013-07-26 |
| Last Update Date | 2013-07-26 |