| NPI | 1164647277 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WANDA DENISE WILSON Administrator 910-846-9196 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2007-04-16 |
| Last Update Date | 2008-06-27 |