| NPI | 1801129127 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNON CHILDRESS Chief Clinical Officer 704-829-4410 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 311ZA0620X Custodial Care Facility Adult Care Home |
| 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities (Licence: NC MHL-036-058) | |
| Enumeration Date | 2009-09-18 |
| Last Update Date | 2017-08-30 |