| NPI | 1972700763 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TOMEKO MICHELLE MOORE President 336-887-0708 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: NC MHL 041 179) |
| Enumeration Date | 2007-06-27 |
| Last Update Date | 2011-07-26 |