| NPI | 1740469022 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLENDA WIGGINS JOHNSON Executive Director 919-252-1868 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2007-11-02 |
| Last Update Date | 2007-11-02 |