| NPI | 1366699449 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TANZY BARROW WALLACE CEO 704-487-6226 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251C00000X Day Training, Developmentally Disabled Services |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 229) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC MHL-023-148) | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 1135) | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 366) | |
| 101YM0800X Counselor, Mental Health | |
| 101YP2500X Counselor, Professional (Licence: NC 5595) | |
| 251S00000X | |
| 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: NC MHL-023-046) | |
| Enumeration Date | 2008-08-20 |
| Last Update Date | 2013-03-26 |