| NPI | 1316060247 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT LEE WATERS Director 252-974-1240 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: NC MHL007061) |
| Enumeration Date | 2007-04-07 |
| Last Update Date | 2009-03-12 |