| NPI | 1306353248 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMINA K A HAQQ Owner 704-728-5068 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2017-12-31 |
| Last Update Date | 2017-12-31 |