| NPI | 1396508263 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTHONY D STAFFORD Chairperson 704-241-1163 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2024-02-02 |
| Last Update Date | 2024-02-02 |