| NPI | 1811001688 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GRETCHEN ANN MCCORD Sole Proprietor 910-219-0635 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: NC MHL-067-112) |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2008-10-02 |