| NPI | 1700178498 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMMY ROGERS Owner 336-266-7073 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: NC mhl-001-215) |
| Enumeration Date | 2011-05-12 |
| Last Update Date | 2011-05-12 |