| NPI | 1720261910 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHANDA TRUESDELL Owner 704-854-4840 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: NC MHL-036-146) |
| Enumeration Date | 2007-12-11 |
| Last Update Date | 2007-12-12 |