| NPI | 1861088064 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MORRIS BUTSITSI Operations Manager 704-777-2188 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2020-12-12 |
| Last Update Date | 2020-12-12 |