| NPI | 1821124116 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELVA COLVIN CEO 910-488-8807 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320700000X Residential Treatment Facility, Physical Disabilities (Licence: NC FCL 026 026) |
| Additional Taxonomies | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: NC MHL 026 655) |
| 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: NC MHL 026 654) | |
| 103TC0700X Psychologist, Clinical | |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| Enumeration Date | 2007-02-23 |
| Last Update Date | 2010-07-01 |