| NPI | 1659633428 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANITA DAVIS Qualified Professional 336-342-3135 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: NC MHL079122) |
| Additional Taxonomies | 251B00000X Case Management |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 324500000X Substance Abuse Rehabilitation Facility | |
| 347C00000X Private Vehicle | |
| Enumeration Date | 2012-06-08 |
| Last Update Date | 2012-06-08 |