| NPI | 1003460833 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIC PAUL MILLER Director 336-340-3821 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2019-07-30 |
| Last Update Date | 2019-07-30 |