| NPI | 1497963136 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY WARD Director 252-714-9056 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: NC MHL-074-185) |
| Enumeration Date | 2007-05-18 |
| Last Update Date | 2007-07-31 |