| NPI | 1831429174 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARRY LEE LACKEY Executive Director 919-414-2860 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: NC MHL-049-121) |
| Additional Taxonomies | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: NC MHL-049-121) |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| Enumeration Date | 2010-01-09 |
| Last Update Date | 2017-08-16 |