| NPI | 1205094984 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAYEE BOHN Director Of Operations 704-430-2064 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: NC MHL-060-1055) |
| Enumeration Date | 2008-05-29 |
| Last Update Date | 2008-05-29 |