| NPI | 1932978293 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ESTHER RICHARDS Director 336-227-3845 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility Adult Care Home |
| Additional Taxonomies | 310500000X Intermediate Care Facility, Mental Illness |
| 315P00000X Intermediate Care Facility, Mentally Retarded | |
| 343900000X Non-emergency Medical Transport (VAN) | |
| 385HR2060X Respite Care Respite Care, Mental Retardation and/or Developmental Disabilities | |
| Enumeration Date | 2023-12-28 |
| Last Update Date | 2024-10-13 |