| NPI | 1366630162 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TEBONY CAMISHA VINCENT Owner/Partner 336-273-0489 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: NC MHL041830) |
| Enumeration Date | 2007-10-05 |
| Last Update Date | 2007-10-05 |