| NPI | 1891357752 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY BENNETT CEO 336-953-0849 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children |
| Additional Taxonomies | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| Enumeration Date | 2019-07-01 |
| Last Update Date | 2019-07-01 |