| NPI | 1225428634 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEITH DERRICK HAITH Director 336-675-4713 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: NC 001-235) |
| Enumeration Date | 2015-01-23 |
| Last Update Date | 2015-01-23 |