| NPI | 1649410598 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIA M. LEWIS Owner/Administrator 919-696-0376 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: NC MHL-092-693) |
| Additional Taxonomies | 251S00000X (Licence: NC MHL-092-693) |
| Enumeration Date | 2009-03-04 |
| Last Update Date | 2009-07-10 |