| NPI | 1962646836 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEREK MITCHELL Operations Manager 336-273-2640 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: NC MHL-041-874) |
| Enumeration Date | 2009-04-23 |
| Last Update Date | 2009-04-23 |