NPI | 1073032470 |
---|---|
Doing Business As | AZALEA WAY |
Entity Type | Organization |
Authorized Contact | MARVIN JOHN SHORT Member 864-313-6967 |
Organization Subpart ? | No |
Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: NC MHL045-119) |
Enumeration Date | 2017-09-18 |
Last Update Date | 2017-09-18 |