| NPI | 1518839372 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROOSEVELT SMITH Owner 704-662-5250 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2025-09-22 |
| Last Update Date | 2025-09-22 |