| NPI | 1467672535 |
|---|---|
| Other Name | COUNTRY PINES GC |
| Entity Type | Organization |
| Authorized Contact | KENNETH MICHAEL SAULS Vice President 919-778-4009 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: NC MHL040014) |
| Enumeration Date | 2007-04-30 |
| Last Update Date | 2020-08-22 |