| NPI | 1245457258 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFERY NMN ROBERTS Director 252-508-6581 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Additional Taxonomies | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: NC MHL-058-022) |
| 251S00000X Community/Behavioral Health (Licence: NC MHL058022) | |
| Enumeration Date | 2007-04-19 |
| Last Update Date | 2024-03-01 |