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, Intellectual and/or Developmental Disabilities (Licence: NC MHL-060-586) |
Enumeration Date | 2007-02-13 |
Last Update Date | 2020-06-08 |