| NPI | 1992500680 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACKIE PARKER Owner 252-412-8111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2025-02-17 |
| Last Update Date | 2025-02-17 |