| NPI | 1104968932 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHELTON LEON MELVIN CEO 910-425-7391 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: NC MHL-026-748) |
| Enumeration Date | 2007-02-12 |
| Last Update Date | 2020-08-22 |