| NPI | 1578160552 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORI ANN WASHINGTON Director 704-622-4918 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children |
| Additional Taxonomies | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children | |
| Enumeration Date | 2020-10-03 |
| Last Update Date | 2020-10-03 |