| NPI | 1548711880 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATELYNN BAKER Executive Director 704-537-4730 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2016-10-21 |
| Last Update Date | 2016-10-21 |