| NPI | 1336205392 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DARIEN J SHAW Dir Residential Services 336-884-4118 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: NC 041-797) |
| Additional Taxonomies | 385H00000X Respite Care |
| Enumeration Date | 2006-12-27 |
| Last Update Date | 2020-08-22 |