| NPI | 1699804302 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WANDA TERESA WILLIAMS Director 252-758-2065 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: NC MHL074133) |
| Enumeration Date | 2007-03-06 |
| Last Update Date | 2020-08-22 |