| NPI | 1023171758 |
|---|---|
| Other Name | EASTSIDE PLACE |
| Entity Type | Organization |
| Authorized Contact | ALFRED LEE MCBRIDE Asso. Executive Director 336-707-0377 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: NC MHL-041-204) |
| Enumeration Date | 2006-12-16 |
| Last Update Date | 2008-06-13 |