| NPI | 1639338825 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNETTE LASHONDA SHUFFORD Owner 919-986-0053 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: NC mhl-092-709) |
| Additional Taxonomies | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: NC mhl-092-709) |
| Enumeration Date | 2008-06-03 |
| Last Update Date | 2008-06-19 |