| NPI | 1790016517 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ZELMA JACKSON WOLFE Administrator, CEO 336-788-3004 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: NC MHL-034-276) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| 253Z00000X In Home Supportive Care | |
| 385H00000X Respite Care (Licence: NC MHL-034-276) | |
| Enumeration Date | 2010-01-18 |
| Last Update Date | 2024-03-08 |