| NPI | 1871617829 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VELDA SIMMONS Owner 704-258-6366 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| 251B00000X Case Management | |
| 251S00000X | |
| 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| 322D00000X Residential Treatment Facility, Emotionally Disturbed Children | |
| 323P00000X Psychiatric Residential Treatment Facility | |
| Enumeration Date | 2007-03-16 |
| Last Update Date | 2023-03-03 |