| NPI | 1740321868 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DARLENE REAVES Owner 910-583-5299 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: NC MHL-026-802) |
| Enumeration Date | 2007-02-09 |
| Last Update Date | 2020-08-22 |