| NPI | 1972882868 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHELIA WALL GRIFFIN Co Owner 336-412-5947 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: NC MHL-041-856) |
| Enumeration Date | 2011-08-09 |
| Last Update Date | 2015-08-03 |