| NPI | 1568194561 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHLEY ROCHELLE PHIFER-DAVIS Owner 704-729-6342 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| 322D00000X Residential Treatment Facility, Emotionally Disturbed Children | |
| Enumeration Date | 2022-06-28 |
| Last Update Date | 2023-06-29 |