| NPI | 1790395457 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN MARIE TEAGUE Administrator 910-338-1810 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2020-08-06 |
| Last Update Date | 2020-08-06 |