| NPI | 1346307238 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZABETH W. MACON Qualified Professional 704-798-7029 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: NC MHL-080-099) |
| Enumeration Date | 2007-01-02 |
| Last Update Date | 2020-08-22 |