| NPI | 1891878518 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARZELL PARKER Qualified Professional 336-686-8582 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: NC MHL-041-765) |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2014-11-19 |