| NPI | 1962387928 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANA FALCON Owner 336-781-9711 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Enumeration Date | 2025-08-08 |
| Last Update Date | 2025-08-08 |