| NPI | 1730873779 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KHALID BAKER CEO 704-750-9557 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2023-06-05 |
| Last Update Date | 2023-06-05 |