| NPI | 1871374876 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MITISHA RATLIFF Owner 336-803-0316 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children |
| Additional Taxonomies | 253Z00000X In Home Supportive Care |
| 315P00000X Intermediate Care Facility, Intellectual Disabilities | |
| 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| 320700000X Residential Treatment Facility, Physical Disabilities | |
| 373H00000X Day Training/Habilitation Specialist | |
| 385H00000X Respite Care | |
| 385HR2060X Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child | |
| Enumeration Date | 2023-10-06 |
| Last Update Date | 2024-11-13 |