| NPI | 1891262010 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WENDY KAY BRADSHER Administrator Manager 336-226-2575 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2018-10-25 |
| Last Update Date | 2018-10-25 |