| NPI | 1356616890 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATASHA MICHELLE DOUGLAS Owner 704-777-0343 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: NC MHL036296) |
| Enumeration Date | 2012-03-16 |
| Last Update Date | 2012-03-16 |