| NPI | 1720116072 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHARON DENISE EVANS Owner 252-258-3940 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: NC MHL-074-147) |
| Enumeration Date | 2007-03-01 |
| Last Update Date | 2020-08-22 |