| NPI | 1992928980 |
|---|---|
| Doing Business As | WESTERN AVENUE FACILITY - ROCKY MOUNT |
| Entity Type | Organization |
| Authorized Contact | KEVIN COCHRAN Financial Assistant 919-866-3287 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: NC MHL-064-005) |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2020-08-22 |