| NPI | 1912064064 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA CARROW HARDISON Owner 252-975-3741 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 251S00000X |
| 311ZA0620X Custodial Care Facility, Adult Care Home | |
| 343900000X Non-emergency Medical Transport (VAN) | |
| Enumeration Date | 2007-01-01 |
| Last Update Date | 2020-06-03 |