| NPI | 1225845175 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMLER REBECCA WALLS ERVIN Owner 704-941-7938 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| Enumeration Date | 2024-12-13 |
| Last Update Date | 2024-12-18 |