| NPI | 1093853822 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIRBY NICKERSON CFO 704-637-2870 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| 322D00000X Residential Treatment Facility, Emotionally Disturbed Children | |
| Enumeration Date | 2007-02-02 |
| Last Update Date | 2022-02-03 |