| NPI | 1326690066 |
|---|---|
| Doing Business As | BOURBONNAIS TERRACE |
| Entity Type | Organization |
| Authorized Contact | SHAUN AHMAD Manager 704-426-8849 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310500000X Intermediate Care Facility, Mental Illness |
| Enumeration Date | 2019-07-12 |
| Last Update Date | 2019-07-12 |