| NPI | 1063254456 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANDON ANTOINE CARRINGTON Owner 336-860-8238 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2024-06-07 |
| Last Update Date | 2024-06-07 |