| NPI | 1033556451 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIRBY DALE NICKERSON CFO 704-637-2870 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 253J00000X Foster Care Agency |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| 322D00000X Residential Treatment Facility, Emotionally Disturbed Children | |
| Enumeration Date | 2013-05-24 |
| Last Update Date | 2013-05-24 |