| NPI | 1245175827 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TYSHEKIA JOHNSON Director/Owner 910-705-2067 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Additional Taxonomies | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children |
| 385H00000X Respite Care | |
| 385HR2055X Respite Care, Respite Care, Mental Illness, Child | |
| 251S00000X Community/Behavioral Health | |
| Enumeration Date | 2026-04-21 |
| Last Update Date | 2026-04-21 |