| NPI | 1710122114 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELODY ROSE JOHNSON CEO 910-536-2253 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children |
| Additional Taxonomies | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| Enumeration Date | 2008-12-14 |
| Last Update Date | 2008-12-27 |