| NPI | 1396484176 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FREDERICKA MICHELLE MARTIN Owner 704-777-8504 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2022-06-01 |
| Last Update Date | 2022-06-01 |