NPI | 1639883564 |
---|---|
Entity Type | Organization |
Authorized Contact | WILLIE A CORNELIUS Owner 704-870-9584 |
Organization Subpart ? | No |
Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children |
Additional Taxonomies | 343900000X Non-emergency Medical Transport (VAN) |
Enumeration Date | 2023-01-05 |
Last Update Date | 2023-06-06 |