| NPI | 1326284761 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CODY THOMAS It Director 704-536-0375 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 323P00000X Psychiatric Residential Treatment Facility (Licence: NC MHL-060-831) |
| Enumeration Date | 2009-01-06 |
| Last Update Date | 2022-05-06 |