| NPI | 1811573025 |
|---|---|
| Other Name | WILMINGTON HOME GROUP HOME |
| Entity Type | Organization |
| Authorized Contact | EDWARD MARTIN WALSH Executive Director 336-207-1545 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 251S00000X |
| 315P00000X Intermediate Care Facility, Intellectual Disabilities | |
| Enumeration Date | 2021-03-19 |
| Last Update Date | 2021-06-03 |