| NPI | 1821140401 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICKEY LEON RIVERS CEO 704-891-5825 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251B00000X Case Management (Licence: NC 8301256B) |
| Additional Taxonomies | 251S00000X |
| 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: NC MHL-060-802) | |
| 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: NC MHL-090-146) | |
| Enumeration Date | 2007-01-17 |
| Last Update Date | 2020-12-04 |