| NPI | 1568226165 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BENITA GRANT Administrator 252-606-4484 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2024-02-13 |
| Last Update Date | 2024-02-13 |