| NPI | 1780719286 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHAROLETTE BOUVIER PATTERSON Adm 910-527-8427 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| Additional Taxonomies | 320600000X Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities (Licence: NC MHL 026766) |
| 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | |
| Enumeration Date | 2007-02-23 |
| Last Update Date | 2016-06-03 |