| NPI | 1841434172 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OCTAVIA DEVONNE SHANKLE Executive Director 704-739-2764 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children |
| Enumeration Date | 2009-04-30 |
| Last Update Date | 2009-04-30 |