| NPI | 1639203326 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHON BLACK Director 704-933-3505 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: NC MHL-013-080) |
| Enumeration Date | 2007-03-15 |
| Last Update Date | 2007-08-01 |