| NPI | 1336288612 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID WILLIAM COULTER Director Owner 704-732-9699 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: NC MHL-055-077) |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2020-08-22 |