| NPI | 1154516565 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARMEN WHITTED Administrator 336-274-1316 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: NC FCL-041-015) |
| Enumeration Date | 2007-09-10 |
| Last Update Date | 2007-09-10 |