| NPI | 1518009992 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM A. BULLOCK President 704-537-1022 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Additional Taxonomies | 320600000X Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities (Licence: NC MHL-060-586) |
| Enumeration Date | 2007-02-13 |
| Last Update Date | 2020-06-08 |