| NPI | 1831332691 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONALD KEITH CHURCH Owner / CEO 704-692-4700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2009-04-09 |
| Last Update Date | 2018-04-23 |