| NPI | 1952659195 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEMETRIUS TILLER Owner 919-986-6565 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2012-08-20 |
| Last Update Date | 2012-08-20 |