NPI | 1508985441 |
---|---|
Entity Type | Organization |
Authorized Contact | LORI GOUGEON Executive Director 704-536-6661 |
Organization Subpart ? | No |
Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
Additional Taxonomies | 251S00000X |
320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: mhl060-240) | |
Enumeration Date | 2007-03-29 |
Last Update Date | 2018-03-20 |