| NPI | 1346415809 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD F. STAPLES Owner 336-635-2000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: NC MHL-079-088) |
| Additional Taxonomies | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children |
| Enumeration Date | 2008-04-25 |
| Last Update Date | 2010-09-13 |