| NPI | 1821146069 |
|---|---|
| Doing Business As | CHARLES STREET FACILITY |
| Entity Type | Organization |
| Authorized Contact | CORNELIUS WILLIAMS President Registered Agent 252-257-9349 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: NC MHL091065) |
| Enumeration Date | 2007-01-06 |
| Last Update Date | 2020-08-22 |