| NPI | 1336766583 |
|---|---|
| Other Name | STEWART STREET HOME |
| Entity Type | Organization |
| Authorized Contact | LORI GOUGEON President CEO 704-536-6661 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2020-07-02 |
| Last Update Date | 2020-07-02 |