| NPI | 1750104246 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TINA ROCHELL MEBANE Owner 336-456-2370 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2024-11-04 |
| Last Update Date | 2026-05-20 |