| NPI | 1205112430 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMESHA SPINKS Owner 336-302-0801 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 322D00000X Residential Treatment Facility, Emotionally Disturbed Children | |
| Enumeration Date | 2011-11-02 |
| Last Update Date | 2019-06-12 |