| NPI | 1063569127 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WAYNE LOUIS GARRIS Executive Director 704-598-5106 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: NC MHL060-871) |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2020-08-22 |