| NPI | 1710005624 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROSA RIVERS AGYEMANG CEO 704-507-2258 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: NC MHL036212) |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2007-12-24 |