| NPI | 1578619938 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIRBY NICKERSON CFO 704-637-2870 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: MHL034174) |
| Enumeration Date | 2007-01-26 |
| Last Update Date | 2017-06-26 |