| NPI | 1023901931 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAQUANNA HENDRICKSON CEO/Director 919-770-5096 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2025-05-30 |
| Last Update Date | 2025-05-30 |