| NPI | 1467599316 |
|---|---|
| Other Name | POLKTON ROAD |
| Entity Type | Organization |
| Authorized Contact | GEORGE TOWLER Director 704-684-0257 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2007-08-15 |