| NPI | 1124182415 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRY MIMS Owner 910-273-5838 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: NC MHL026669) |
| Enumeration Date | 2006-12-20 |
| Last Update Date | 2007-07-10 |