| NPI | 1851589659 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICIA WILLIAMS DICKENS Owner/Operator/Administrator 252-823-3699 |
| Organization Subpart ? | No |
| Primary Taxonomy | 315P00000X Intermediate Care Facility, Intellectual Disabilities |
| Enumeration Date | 2007-10-07 |
| Last Update Date | 2007-10-07 |