| NPI | 1780913970 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLETTE CARRINGTON Administrative Assistant 336-292-1555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: NC MHL-041-837) |
| Additional Taxonomies | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: NC MHL-041-728) |
| 323P00000X Psychiatric Residential Treatment Facility (Licence: NC MHL-041-837) | |
| 323P00000X Psychiatric Residential Treatment Facility (Licence: NC MHL-041-728) | |
| Enumeration Date | 2009-12-17 |
| Last Update Date | 2015-09-16 |