| NPI | 1154558955 |
|---|---|
| Other Name | EDGEWOOD STREET |
| Entity Type | Organization |
| Authorized Contact | CINDY JONES CFO 704-986-1522 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| 310400000X Assisted Living Facility | |
| Enumeration Date | 2009-06-18 |
| Last Update Date | 2025-09-08 |