| NPI | 1568611440 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANICKA PORTER Executive Director 919-803-9392 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: NC MHL-051-167) |
| Additional Taxonomies | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: NC MHL-051-166) |
| Enumeration Date | 2008-09-16 |
| Last Update Date | 2008-09-23 |