| NPI | 1225670698 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ISAAC BLOUNT Consulting 919-797-4615 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children |
| Enumeration Date | 2019-10-17 |
| Last Update Date | 2024-12-16 |