| NPI | 1962731463 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMELA COSTEN DANIELS Administrator/Owner 252-972-6995 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: NC MHL-033-068) |
| Enumeration Date | 2009-12-11 |
| Last Update Date | 2009-12-11 |