| NPI | 1720187420 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORI A GOUGEON President 704-536-6661 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 251B00000X Case Management |
| 251C00000X Day Training, Developmentally Disabled Services | |
| 253Z00000X In Home Supportive Care | |
| 311ZA0620X Custodial Care Facility, Adult Care Home | |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2018-11-15 |