| NPI | 1942714522 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATASHA EARL Executive Director 704-273-0386 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 251S00000X |
| 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| Enumeration Date | 2017-11-19 |
| Last Update Date | 2017-11-19 |