| NPI | 1639219348 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEROME S JOHNSON Co Director 910-670-1989 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: NC MHL026799) |
| Enumeration Date | 2007-02-08 |
| Last Update Date | 2020-08-22 |