| NPI | 1467670752 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZABETH L THEISEN Compliance And Contracts Manager 336-275-7896 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NC MHL-0410632) |
| Additional Taxonomies | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2024-05-13 |