| NPI | 1134671399 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH WARD BLANCHARD CEO 252-216-9374 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2016-11-03 |
| Last Update Date | 2017-06-07 |