| NPI | 1407076334 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TYRAN LENNON Executive Director 980-581-1404 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children |
| Enumeration Date | 2007-04-25 |
| Last Update Date | 2020-08-22 |