| NPI | 1801125570 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TYSON RULON FEARRINGTON Director/Owner 336-684-4493 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: NC 320800000X) |
| Enumeration Date | 2009-12-09 |
| Last Update Date | 2009-12-09 |