| NPI | 1376501973 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALICE D. SMITH Executive Director 910-323-1817 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X |
| Additional Taxonomies | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| 324500000X Substance Abuse Rehabilitation Facility | |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2012-01-10 |