| NPI | 1386780724 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID W FORSYTHE Executive Director 336-599-9421 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: NC MHL 073 037) |
| Additional Taxonomies | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: NC MHL 073 037) |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2013-08-29 |