| NPI | 1720136930 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICKIE SMITH YELVERTON CEO 919-872-6220 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YM0800X Counselor, Mental Health | |
| 101YP2500X Counselor, Professional | |
| 251S00000X (Licence: NC MHL040029) | |
| 251S00000X (Licence: NC MHL-040-040) | |
| 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: NC MHL-098-137) | |
| 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: NC MHL040029) | |
| 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: NC MHL-040-042) | |
| Enumeration Date | 2007-01-07 |
| Last Update Date | 2021-02-03 |