| NPI | 1770727281 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRYSTAL DEMETRUS SHOFFNER Executive Director 336-549-1081 |
| Organization Subpart ? | No |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility (Licence: NC MHL-001-074) |
| Additional Taxonomies | 323P00000X Psychiatric Residential Treatment Facility (Licence: NC MHL-076-098) |
| Enumeration Date | 2009-04-28 |
| Last Update Date | 2016-09-19 |