| NPI | 1669810560 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIC M. PAGE Operations Manager 336-272-8335 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NC MHL-079-078) |
| Additional Taxonomies | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: NC MHL-079-078) |
| 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: NC MHL-079-078) | |
| Enumeration Date | 2013-06-13 |
| Last Update Date | 2016-03-04 |