| NPI | 1164946851 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANICE WILSON Director 252-227-2272 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2017-08-03 |
| Last Update Date | 2018-03-17 |