| NPI | 1477864734 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CODY MATTHEW THOMAS Director Of It 704-536-0375 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 323P00000X Psychiatric Residential Treatment Facility |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry | |
| 253J00000X Foster Care Agency | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2010-07-01 |
| Last Update Date | 2019-10-29 |