| NPI | 1912080805 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICK AVENT Owner 252-212-5918 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2020-08-22 |