| NPI | 1538720396 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVI CUNNINGHAM Director Of Operations 980-448-4614 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| Enumeration Date | 2019-06-24 |
| Last Update Date | 2020-10-06 |