| NPI | 1164658597 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DESARETA JONES Director/Owner 704-609-5288 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children |
| Additional Taxonomies | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: NC 036-269) |
| Enumeration Date | 2009-05-29 |
| Last Update Date | 2020-10-20 |