| NPI | 1548002751 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAQUETA CROWDER Co Owner 704-953-7937 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Additional Taxonomies | 251S00000X |
| 322D00000X Residential Treatment Facility, Emotionally Disturbed Children | |
| Enumeration Date | 2024-06-10 |
| Last Update Date | 2024-06-10 |