| NPI | 1770721813 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERESA CELESTE MULLEN Executive Director 919-345-5847 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: NC MHL-032-470) |
| Additional Taxonomies | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: NC MHL-032-470) |
| Enumeration Date | 2009-01-28 |
| Last Update Date | 2009-01-28 |