| NPI | 1134325509 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EUNICE MAE STEWARD Director 910-884-7794 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: NC MHL-026-836) |
| Additional Taxonomies | 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities (Licence: NC MHL-026-836) |
| Enumeration Date | 2007-06-22 |
| Last Update Date | 2020-08-22 |