| NPI | 1508049107 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHILLE EVETTE STANFORD PETTIFORD Director 919-730-9917 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: NC mhl-032-421) |
| Enumeration Date | 2007-12-06 |
| Last Update Date | 2007-12-06 |