| NPI | 1609211309 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARRY ALVIN LEATH CEO 336-227-8030 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 174400000X Specialist |
| 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: NC MHL001073) | |
| Enumeration Date | 2013-05-08 |
| Last Update Date | 2019-12-04 |