| NPI | 1689970956 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIAN ALSTON WALLACE Director 336-908-1152 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: NC MHL-041-1005) |
| Enumeration Date | 2011-02-04 |
| Last Update Date | 2011-02-04 |