| NPI | 1235378522 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS TREVOUR SHEPARD Owner/Operator 910-376-2276 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children |
| 385H00000X Respite Care | |
| Enumeration Date | 2009-02-11 |
| Last Update Date | 2009-02-11 |