| NPI | 1548300221 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MILTON EARL MOORE Executive Director 2562-367-0918 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: NC 074-148) |
| Enumeration Date | 2007-02-08 |
| Last Update Date | 2020-08-22 |