| NPI | 1184489460 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANDON BLASSE Executive Director 704-796-1156 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2024-02-16 |
| Last Update Date | 2024-06-12 |