| NPI | 1154706307 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARRY REID SNIDER Executive Director 704-376-7447 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: NC MHL 060-1300) |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility (Licence: NC MHL-060-1300) |
| Enumeration Date | 2015-07-29 |
| Last Update Date | 2017-05-05 |