| NPI | 1164641601 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONNA D. P. BLACK Chief Executive Officer 910-574-7239 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310500000X Intermediate Care Facility, Mental Illness (Licence: NC MHL-026-835) |
| Enumeration Date | 2007-04-24 |
| Last Update Date | 2020-08-22 |