| NPI | 1053637710 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WARNER LEAK President/CEO 704-985-1189 |
| Organization Subpart ? | No |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2010-04-20 |
| Last Update Date | 2018-08-14 |