| NPI | 1265690390 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADRIAN TERRELL FUNCHESS CEO/Owner 336-501-8643 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: NC MHL-041-840) |
| Additional Taxonomies | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: NC MHL-041-840) |
| Enumeration Date | 2008-05-27 |
| Last Update Date | 2008-07-30 |