| NPI | 1942421862 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHON BLACK Owner 704-933-3505 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2020-08-22 |