| NPI | 1154569432 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GUY LAND Owner 336-907-1034 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: NC MHL-041-890) |
| Enumeration Date | 2009-01-26 |
| Last Update Date | 2014-07-17 |