| NPI | 1124396056 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AUDREY BELLAMY Director 910-641-0000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: NC 01980) |
| Enumeration Date | 2011-12-07 |
| Last Update Date | 2012-08-15 |