| NPI | 1982087458 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTHONY PATTERSON Director 336-379-7584 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: NC MHL041718) |
| Enumeration Date | 2015-07-02 |
| Last Update Date | 2015-07-02 |