| NPI | 1538221080 |
|---|---|
| Other Name | MARY'S PLACE |
| Entity Type | Organization |
| Authorized Contact | SAUNDRA R FANTI Administrator 910-846-5635 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children |
| Enumeration Date | 2006-12-14 |
| Last Update Date | 2020-08-22 |