| NPI | 1841431517 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NIKA TAYLOR POWELL Owner 252-567-3461 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: NC MHL-033-57) |
| Enumeration Date | 2009-03-10 |
| Last Update Date | 2009-03-10 |