| NPI | 1184803686 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BETTY ANN GRAVELY Owner/Director 704-739-6650 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: NC MHL036249) |
| Additional Taxonomies | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: NC MHL036249) |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: NC MHL036249) | |
| Enumeration Date | 2007-10-31 |
| Last Update Date | 2007-10-31 |