| NPI | 1285838805 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLENDA T JACKSON Director 910-628-7171 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: NC MHL078158) |
| Enumeration Date | 2007-06-14 |
| Last Update Date | 2020-08-22 |