| NPI | 1174682678 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHEY CHYREL GLENN Director 704-491-6558 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311Z00000X Custodial Care Facility (Licence: NC hc3370) |
| Enumeration Date | 2006-12-08 |
| Last Update Date | 2008-08-01 |