| NPI | 1407258189 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIC M. PAGE Operations Manager 336-272-8335 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: NC MHL-041-1104) |
| Additional Taxonomies | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: NC MHL-041-1104) |
| Enumeration Date | 2014-09-24 |
| Last Update Date | 2015-08-03 |