| NPI | 1972954113 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNE JEFFRIES Owner 980-297-8964 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: NC 623-203) | |
| Enumeration Date | 2016-06-29 |
| Last Update Date | 2022-12-08 |