| NPI | 1356489363 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICKIE MCDUFFIE Reimbursement Coord 704-833-0154 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 251B00000X Case Management |
| 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: NC MHL-036-285) | |
| Enumeration Date | 2007-02-02 |
| Last Update Date | 2018-03-27 |