| NPI | 1285931139 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEMETRIUS TILLER Owner 919-521-8112 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: NC MHL-092-785) |
| Enumeration Date | 2011-02-11 |
| Last Update Date | 2011-02-11 |