| NPI | 1801094917 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RECHON BLACK Executive Director 704-933-3505 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2007-07-10 |
| Last Update Date | 2020-08-22 |