| NPI | 1174048078 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAUNTA BETHEA Program Development 704-780-0432 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children |
| Enumeration Date | 2017-08-11 |
| Last Update Date | 2017-08-11 |