| NPI | 1821143140 |
|---|---|
| Other Name | ELGYWOOD LANE |
| Entity Type | Organization |
| Authorized Contact | HATTIE S. MALONE Executive Director 704-532-0566 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: NC MHL-060-751) |
| Enumeration Date | 2007-01-25 |
| Last Update Date | 2020-08-22 |