| NPI | 1700175015 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORI MANESS Controller 704-986-1523 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children |
| 324500000X Substance Abuse Rehabilitation Facility | |
| Enumeration Date | 2011-04-07 |
| Last Update Date | 2026-05-27 |