| NPI | 1275392110 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHYLLIS ALLEN CEO 704-574-5921 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 251S00000X |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| Enumeration Date | 2024-03-14 |
| Last Update Date | 2024-03-14 |