| NPI | 1811163017 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENISE DAVIS Owner/ Operator 252-977-1210 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: NC MHL-033-056) |
| Enumeration Date | 2008-05-07 |
| Last Update Date | 2008-05-07 |