| NPI | 1760516488 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GALE VALENCIA RAY Director 910-261-4553 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: NC MHL-047-080) |
| Enumeration Date | 2007-03-15 |
| Last Update Date | 2020-08-22 |