| NPI | 1750525648 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEREK MITCHELL Operations Manager 336-273-2640 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility |
| Enumeration Date | 2009-04-23 |
| Last Update Date | 2015-04-02 |