| NPI | 1114422813 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | INGRID CRAWFORD Program Manager 704-297-8286 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2018-03-26 |
| Last Update Date | 2018-03-26 |