NPI | 1497968762 |
---|---|
Other Name | COUNTRY PINES #1 |
Entity Type | Organization |
Authorized Contact | KENNETH MICHAEL SAULS Vice President 919-778-4009 |
Organization Subpart ? | No |
Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: NC MHL096117) |
Additional Taxonomies | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: NC MHL096117) |
Enumeration Date | 2007-05-07 |
Last Update Date | 2007-09-04 |