| NPI | 1881891521 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CALVIN DONNELL ELY Co Administrator 910-683-6476 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: NC MHL-047-049) |
| Enumeration Date | 2007-06-27 |
| Last Update Date | 2009-05-08 |