| NPI | 1598048225 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CELESTE INEZ DOMINGUEZ CEO 704-873-2211 |
| Organization Subpart ? | No |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility (Licence: NC MHL-049-087) |
| Enumeration Date | 2011-09-20 |
| Last Update Date | 2018-07-03 |