| NPI | 1780951244 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAULA A ERVIN President 252-200-4930 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320700000X Residential Treatment Facility, Physical Disabilities |
| Additional Taxonomies | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| 174H00000X Health Educator | |
| 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| Enumeration Date | 2011-11-28 |
| Last Update Date | 2011-12-03 |