| NPI | 1205996899 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LONNIE JAMES TUCKER CEO 704-734-1040 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: NC MHL-023-108) |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2020-08-22 |