| NPI | 1518010206 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HAYWOOD LEE DUNCAN Executive Director 704-207-6266 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: NC MHL-090-142) |
| 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: NC MHL-090-159) | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 101YM0800X Counselor, Mental Health | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2007-01-18 |
| Last Update Date | 2008-08-06 |