NPI | 1609852201 |
---|---|
Entity Type | Organization |
Authorized Contact | LAURIE DODGE HIBBERT V. President 704-279-1199 |
Organization Subpart ? | No |
Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: NC MHL-080-035) |
Additional Taxonomies | 323P00000X Psychiatric Residential Treatment Facility (Licence: NC MHL-080-035) |
322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: NC MHL-080-035) | |
Enumeration Date | 2005-12-16 |
Last Update Date | 2021-01-03 |