| NPI | 1972633014 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GALE PURVIS Executive Director 252-237-4778 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: NC MHL-098-078) |
| Enumeration Date | 2007-03-07 |
| Last Update Date | 2020-08-22 |