| NPI | 1194528976 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRADFORD ANTONIO CARRINGTON Director 336-624-0940 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children |
| Enumeration Date | 2025-03-28 |
| Last Update Date | 2025-03-28 |