| NPI | 1760717094 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROSALINA TEEL Administrator 910-592-7451 |
| Organization Subpart ? | No |
| Primary Taxonomy | 315P00000X Intermediate Care Facility, Intellectual Disabilities |
| Enumeration Date | 2009-10-05 |
| Last Update Date | 2009-10-05 |