| NPI | 1407973068 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONNETTA R DALTON Business Manager 336-965-0577 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: NC MHL-041-778) |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2007-03-26 |
| Last Update Date | 2008-06-19 |