| NPI | 1275699100 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HERMAN BLACK Office Director 704-933-3505 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: NC MHL-013-093) |
| Enumeration Date | 2006-12-28 |
| Last Update Date | 2007-08-01 |