| NPI | 1962949081 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YUSHONDA EILEEN MIDGETTE Owner/Representative 910-538-1096 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2017-01-26 |
| Last Update Date | 2017-01-28 |