| NPI | 1750575270 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LESLIE COLEY Billing Supervisor 910-483-0734 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: NC MHL032194) |
| Enumeration Date | 2007-08-28 |
| Last Update Date | 2007-08-28 |