| NPI | 1013262500 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY ELIZABETH PORRAS KANTROWITZ Accounts Receivable 704-536-0375 |
| Organization Subpart ? | No |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility |
| Enumeration Date | 2012-07-20 |
| Last Update Date | 2017-11-09 |