| NPI | 1730929274 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COSTELLA GREEN President 910-676-0362 |
| Organization Subpart ? | No |
| Primary Taxonomy | 385H00000X Respite Care |
| Additional Taxonomies | 253J00000X Foster Care Agency |
| 253Z00000X In Home Supportive Care | |
| 261QA0600X Clinic/Center Adult Day Care | |
| 310400000X Assisted Living Facility | |
| 3104A0625X Assisted Living Facility Assisted Living, Mental Illness | |
| 385HR2065X Respite Care Respite Care, Physical Disabilities, Child | |
| Enumeration Date | 2024-05-31 |
| Last Update Date | 2024-05-31 |