| NPI | 1518108687 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINA JOHNSON Owner 336-350-3557 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2009-03-18 |
| Last Update Date | 2022-07-21 |