| NPI | 1558927590 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSE TALL CEO 704-975-6118 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children |
| Additional Taxonomies | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| 323P00000X Psychiatric Residential Treatment Facility | |
| Enumeration Date | 2019-05-15 |
| Last Update Date | 2019-05-15 |