| NPI | 1013969922 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOM E ELMORE Executive Director 336-784-9470 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility (Licence: NC MHL 034004) |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2024-04-05 |