| NPI | 1720317217 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYNN SKIDMORE CEO 704-507-2824 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: NC MHL-049-123) |
| Additional Taxonomies | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children |
| 323P00000X Psychiatric Residential Treatment Facility (Licence: NC MHL-049-123) | |
| Enumeration Date | 2009-12-14 |
| Last Update Date | 2017-12-07 |