| NPI | 1942048046 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNIE STACKHOUSE Owner 910-261-3633 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children |
| Additional Taxonomies | 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| 385H00000X Respite Care | |
| Enumeration Date | 2024-07-15 |
| Last Update Date | 2025-08-17 |