| NPI | 1932236791 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LOTHEL WATSON Owner 704-492-0406 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251B00000X Case Management |
| Additional Taxonomies | 251C00000X |
| 251S00000X Community/Behavioral Health | |
| 251X00000X Supports Brokerage | |
| 322D00000X Residential Treatment Facility, Emotionally Disturbed Children | |
| 320700000X Residential Treatment Facility, Physical Disabilities | |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| 101YS0200X Counselor, School | |
| Enumeration Date | 2007-02-28 |
| Last Update Date | 2008-06-30 |