| NPI | 1801762661 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORI GOUGEON Executive Director 704-536-6661 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Enumeration Date | 2025-10-16 |
| Last Update Date | 2025-10-16 |