| NPI | 1891922217 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BETTY FORSYTHE Owner 252-234-6163 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: NC MHL098132) |
| Enumeration Date | 2009-06-11 |
| Last Update Date | 2009-06-11 |