| NPI | 1457574436 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAUNDRA R FANTI Administrator 910-846-5635 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: NC MHL-010-054) |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2020-08-22 |