| NPI | 1134541758 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VINCENT MARLEY Director 336-226-4103 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: NC MHL-001-161) |
| Enumeration Date | 2014-01-16 |
| Last Update Date | 2014-01-16 |