| NPI | 1073766820 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILHELMENIA DEBRO Owner 252-459-8777 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: NC MHL-064-094) |
| Additional Taxonomies | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children |
| Enumeration Date | 2008-10-24 |
| Last Update Date | 2008-12-08 |