| NPI | 1316444763 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLEY CARR Consultant 252-204-2880 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2018-04-11 |
| Last Update Date | 2018-04-11 |