| NPI | 1619123189 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GAYLAND ANTHONY OLIVER Owner 336-456-7705 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: NC 041871) |
| Enumeration Date | 2008-08-14 |
| Last Update Date | 2008-08-14 |