| NPI | 1871735233 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIFFANY DELORSE MONROE CEO 910-273-5473 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: NC MHL-047-112) |
| Enumeration Date | 2009-04-01 |
| Last Update Date | 2009-04-01 |