| NPI | 1811263932 |
|---|---|
| Doing Business As | NONE |
| Entity Type | Organization |
| Authorized Contact | KEYANNA N BODRICK President 704-430-1776 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children |
| Enumeration Date | 2012-03-23 |
| Last Update Date | 2012-03-23 |