| NPI | 1821142282 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TANIS WATKINS CEO 704-506-6888 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children |
| Additional Taxonomies | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2011-06-23 |