| NPI | 1831592864 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IGNACIO KIRK CEO 919-696-6071 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: NC MHL-09-2503) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NC C 000396) |
| Enumeration Date | 2014-10-05 |
| Last Update Date | 2015-03-30 |