| NPI | 1912136573 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARRY LEE LACKEY President/Executive Director 919-414-2860 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NC MHL-032-500) |
| Additional Taxonomies | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2009-07-03 |
| Last Update Date | 2017-06-21 |