| NPI | 1083379085 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA JOHNSON Owner 336-303-5844 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2021-11-03 |
| Last Update Date | 2021-11-03 |