| NPI | 1205093440 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | T SHAWN GIBBS Director 704-942-8410 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: NC 049-143) |
| Additional Taxonomies | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: NC 013-033) |
| Enumeration Date | 2008-05-16 |
| Last Update Date | 2018-03-17 |