| NPI | 1689853467 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GAIL COACHMAN Owner 336-299-6644 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: NC MHL-041-847) |
| Additional Taxonomies | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: NC MHL-041-847) |
| Enumeration Date | 2007-10-30 |
| Last Update Date | 2008-04-09 |