| NPI | 1861530073 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JERRY LORENZO FLOOD Director 910-527-0258 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: NC MHL026562) |
| Enumeration Date | 2007-02-01 |
| Last Update Date | 2020-08-22 |