| NPI | 1023569522 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WENDY JONES Adminsitrator 252-946-2324 |
| Organization Subpart ? | No |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility (Licence: NC MHL-007-083) |
| Enumeration Date | 2016-10-19 |
| Last Update Date | 2016-10-19 |