| NPI | 1508241639 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICKIE SMITH YELVERTON Executive Program Director 919-961-5123 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: NC MHL-092-923) |
| Additional Taxonomies | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: NC MHL-092-923) |
| Enumeration Date | 2015-07-30 |
| Last Update Date | 2015-09-02 |