| NPI | 1003952227 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REGINA DEPASS Executive Director 704-323-9266 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: NC 060-857) |
| Additional Taxonomies | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: NC MHL#060-857) |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2018-08-29 |