| NPI | 1205092376 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARSHA DAYMON-ADAMS Owner/Operator 704-496-1186 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: NC MHL060-1060) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 103TM1800X Psychologist, Intellectual & Developmental Disabilities | |
| 1041C0700X Social Worker, Clinical | |
| 103TA0700X Psychologist, Adult Development & Aging | |
| Enumeration Date | 2008-07-29 |
| Last Update Date | 2016-11-23 |