| NPI | 1053552778 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEMETRIUS CRAYTON Owner 704-241-0690 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: NC MHL036267) |
| Enumeration Date | 2009-03-09 |
| Last Update Date | 2009-03-09 |