| NPI | 1750412516 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENSIE D LUCAS Assistant Area Director 910-323-0601 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: NC MHL-026-107) |
| 324500000X Substance Abuse Rehabilitation Facility (Licence: NC MHL-026-107) | |
| 385H00000X Respite Care | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry | |
| Enumeration Date | 2007-03-07 |
| Last Update Date | 2008-01-16 |