| NPI | 1356640247 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VELDA SIMMONS Program Director/ Qm Director 704-548-2445 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: NC 251S00000X) |
| Additional Taxonomies | 251B00000X Case Management |
| 251S00000X | |
| 253Z00000X In Home Supportive Care | |
| 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| 322D00000X Residential Treatment Facility, Emotionally Disturbed Children | |
| 323P00000X Psychiatric Residential Treatment Facility | |
| Enumeration Date | 2011-03-18 |
| Last Update Date | 2023-03-03 |