| NPI | 1033736053 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIA FUNDERBURK Administrator 704-488-3458 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 174200000X Meals |
| 177F00000X Lodging | |
| 251B00000X Case Management | |
| 251C00000X Day Training, Developmentally Disabled Services | |
| Enumeration Date | 2020-06-26 |
| Last Update Date | 2020-06-26 |