| NPI | 1902818859 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TROY Z. PELSHAK Director 704-494-8711 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: NC MHL-060-928) |
| Additional Taxonomies | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: NC MHL-060-819) |
| Enumeration Date | 2006-08-12 |
| Last Update Date | 2020-08-22 |