| NPI | 1467006353 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GENITA DOUGLAS Director Of Operations 704-214-1174 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Additional Taxonomies | 251S00000X |
| 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children | |
| Enumeration Date | 2019-07-29 |
| Last Update Date | 2019-07-29 |