| NPI | 1083919518 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATONYA FAYE TINNIN Qualified Professional/ Director 336-350-5492 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: NC 041-997) |
| Enumeration Date | 2011-01-13 |
| Last Update Date | 2011-01-13 |