| NPI | 1144402926 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMERA B. WILSON Owner/Administrator 336-213-0975 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: NC MHL-001-144) |
| Enumeration Date | 2007-12-03 |
| Last Update Date | 2007-12-03 |