| NPI | 1194922294 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK HAYNES HENNING Qualified Professional 704-884-2511 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children |
| Enumeration Date | 2007-07-02 |
| Last Update Date | 2007-08-22 |