| NPI | 1407224058 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THERESA DEBERRY BRADY Director 336-508-2847 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2015-09-11 |
| Last Update Date | 2015-09-11 |