| NPI | 1114051349 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHON BLACK Official Director 704-933-3505 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: NC MHL-013-123) |
| Additional Taxonomies | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: NC MHL-013-061) |
| 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: NC MHL-013-065) | |
| 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: NC MHL-013-111) | |
| 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: NC MHL-013-112) | |
| 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: NC MHL-013-122) | |
| 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: NC MHL-013-125) | |
| 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: NC MHL-013-130) | |
| 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: NC MHL-013-131) | |
| Enumeration Date | 2007-03-16 |
| Last Update Date | 2020-08-22 |