| NPI | 1033259015 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GWENDOLYN LAVERN GRAHAM Administrative Program Director 704-395-2432 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: NC mhl060-836) |
| Enumeration Date | 2007-02-07 |
| Last Update Date | 2020-08-22 |