| NPI | 1013466416 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROSALYN RENEE JACKSON Program Administrator 704-534-5722 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: NC MHL-060-1363) |
| Enumeration Date | 2016-09-26 |
| Last Update Date | 2018-06-29 |