| NPI | 1275791550 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMMARIA LUCILIA BOYD Owner/Operator 704-345-2019 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: NC MHL0601106) |
| Enumeration Date | 2008-05-23 |
| Last Update Date | 2011-12-07 |