| NPI | 1013100031 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LONDON CORREL DAVIS Member/Manager 336-570-6967 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: NC MHL-001-146) |
| Enumeration Date | 2007-08-22 |
| Last Update Date | 2007-08-22 |