| NPI | 1669989554 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUSSELL GUCCIO Director Of Operations 704-844-6958 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2018-01-02 |
| Last Update Date | 2024-04-25 |