| NPI | 1871683300 |
|---|---|
| Doing Business As | DBA RESIDENTIAL & SUPPORTIVE SERVICES |
| Entity Type | Organization |
| Authorized Contact | THOMASINA W WILLIAMS Administrator 910-293-4919 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: NC MHL031021) |
| Additional Taxonomies | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: NC MHL031018) |
| 172V00000X Community Health Worker | |
| 101YP2500X Counselor, Professional | |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2009-06-24 |