| NPI | 1053599589 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CONTESSA DENISE STRADER Owner 336-254-1805 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: NC MHL-041-858) |
| Enumeration Date | 2008-02-06 |
| Last Update Date | 2008-02-06 |