| NPI | 1962670240 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TREAVER HOUENOU Director 336-373-1285 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: NC MHL-041-859) |
| Enumeration Date | 2008-02-20 |
| Last Update Date | 2008-02-20 |