| NPI | 1851072169 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMEER GREEN Executive Director 704-891-6404 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2023-07-28 |
| Last Update Date | 2023-07-28 |