| NPI | 1467513101 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HATTIE FAYE BORDEAUX Clinical Director 252-353-4250 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: NC MHL-074-132) |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2020-08-22 |