| NPI | 1396547881 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IVEY TAYLOR Director 704-675-1012 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children |
| Enumeration Date | 2025-03-25 |
| Last Update Date | 2025-03-25 |