| NPI | 1902047095 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MINNIE C WHITEHEAD Owner 252-446-4343 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: NC MHL-033-055) |
| Enumeration Date | 2009-03-18 |
| Last Update Date | 2009-03-18 |