| NPI | 1952027450 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATRISH GODDARD CEO 252-493-1860 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2022-10-17 |
| Last Update Date | 2022-10-17 |