| NPI | 1194510768 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADRIENNE CLARISSA BOLIN CEO 704-466-5504 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 251B00000X Case Management |
| 251C00000X Day Training, Developmentally Disabled Services | |
| 251K00000X Public Health or Welfare | |
| 251S00000X Community/Behavioral Health | |
| 252Y00000X Early Intervention Provider Agency | |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| 324500000X Substance Abuse Rehabilitation Facility | |
| Enumeration Date | 2025-04-14 |
| Last Update Date | 2025-04-23 |