| NPI | 1124771688 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIZZY R BROWN Owner 336-417-9914 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2022-02-03 |
| Last Update Date | 2022-02-03 |