| NPI | 1578815940 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACK MARCELLOUS PHILLIPS Executive Director/CEO 704-392-9220 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: NC 060-350) |
| Enumeration Date | 2012-10-10 |
| Last Update Date | 2012-10-10 |