| NPI | 1922144351 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA S DAY Clinical Director 336-599-9421 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities (Licence: NC MHL 073 034) |
| Additional Taxonomies | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: NC MHL 073 034) |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2025-07-02 |