| NPI | 1518105642 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KHALID TSALANI GREENAWAY Owner 336-253-5286 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: NC MHL-041-888) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: NC MHL-041-888) |
| Enumeration Date | 2009-01-27 |
| Last Update Date | 2009-11-17 |