| NPI | 1851133326 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHERIE' WAGNER Co Owner/Executive Director 704-771-0985 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2024-06-06 |
| Last Update Date | 2024-06-13 |