| NPI | 1053626135 |
|---|---|
| Doing Business As | PELHAM GROUP HOME #4 |
| Entity Type | Organization |
| Authorized Contact | MILDRED WILSON Owner 910-630-6757 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: NC MHL-2620) |
| Enumeration Date | 2010-08-12 |
| Last Update Date | 2010-08-12 |