| NPI | 1679178362 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEWITT DIXON COO 704-840-5662 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2020-12-01 |
| Last Update Date | 2020-12-01 |