| NPI | 1215127675 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JERRIS CORNELIUS MCPHAIL Owner 910-299-0099 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: NC MHL082071) |
| Enumeration Date | 2007-07-31 |
| Last Update Date | 2008-03-28 |