| NPI | 1003012758 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEOVON KENANE MARTIN CEO Director 336-254-6770 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: NC MHL-041-764) |
| Enumeration Date | 2007-06-21 |
| Last Update Date | 2009-06-01 |