| NPI | 1578743795 |
|---|---|
| Doing Business As | EBENEZER HOUSE |
| Entity Type | Organization |
| Authorized Contact | BEVERLIE ROSE GRIZZLE Habtechican 336-491-7190 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: NC MHL-034-218) |
| Enumeration Date | 2007-11-05 |
| Last Update Date | 2009-08-25 |