| NPI | 1609696723 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JARVIS COBB CEO 910-823-6537 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2024-10-14 |
| Last Update Date | 2024-10-14 |