| NPI | 1669512125 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MONROE SCOTT WRAY Fiscal Affairs Officer 336-623-8706 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: NC 079010) |
| Additional Taxonomies | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: NC 079079) |
| Enumeration Date | 2007-02-07 |
| Last Update Date | 2020-08-22 |