| NPI | 1699549600 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REIGN LOTHEL WATSON President 704-490-5511 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| 323P00000X Psychiatric Residential Treatment Facility | |
| Enumeration Date | 2023-11-09 |
| Last Update Date | 2023-11-09 |