NPI | 1780724708 |
---|---|
Entity Type | Organization |
Authorized Contact | CINDY JONES CFO 704-986-1522 |
Organization Subpart ? | No |
Primary Taxonomy | 315P00000X Intermediate Care Facility, Intellectual Disabilities |
Additional Taxonomies | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: NC MHL-090-010) |
251S00000X | |
311Z00000X Custodial Care Facility | |
320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
Enumeration Date | 2007-02-07 |
Last Update Date | 2021-03-31 |