| NPI | 1568559540 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEOVON KENANE MARTIN CEO/ Director 336-254-6770 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: NC MHL-041-764) |
| Enumeration Date | 2006-10-09 |
| Last Update Date | 2011-11-16 |