| NPI | 1043726326 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHIRLEY SIMPSON President 252-340-1530 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 3245S0500X Substance Abuse Rehabilitation Facility Substance Abuse Treatment, Children |
| Enumeration Date | 2017-12-21 |
| Last Update Date | 2020-05-12 |