| NPI | 1831702562 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DUSTIN X JOHNSON CEO 704-450-2117 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2020-08-24 |
| Last Update Date | 2026-01-06 |