| NPI | 1891862413 |
|---|---|
| Other Name | LIMITED LIABILITY CORPORATION |
| Entity Type | Organization |
| Authorized Contact | RONALD MACK JOHNSON Director 919-452-9276 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: NC MHL-032-336) |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2009-11-03 |