| NPI | 1568602746 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LA'SHELL CLARK Founder 704-568-1490 |
| Organization Subpart ? | No |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2009-02-27 |
| Last Update Date | 2019-10-18 |