| NPI | 1902588296 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES N IBEZIAKO Owner 919-426-0280 |
| Organization Subpart ? | No |
| Primary Taxonomy | 315P00000X Intermediate Care Facility, Intellectual Disabilities |
| Enumeration Date | 2023-08-04 |
| Last Update Date | 2023-08-04 |