| NPI | 1326892233 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACKIE C. HAINES Owner 336-988-9715 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2024-04-16 |
| Last Update Date | 2024-04-16 |