| NPI | 1710773098 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN BLASSE Owner 704-576-4198 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2025-04-15 |
| Last Update Date | 2025-04-28 |