| NPI | 1407912843 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOEL KEITH DENSON Direct Owner 704-867-5733 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: NC MHL-055-102) |
| Additional Taxonomies | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: NC MHL-055-103) |
| 251B00000X Case Management | |
| 251S00000X | |
| 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: NC MHL-036-201) | |
| 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: NC MHL-036-216) | |
| 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: NC MHL-036-217) | |
| Enumeration Date | 2006-12-29 |
| Last Update Date | 2020-08-22 |