| NPI | 1962228486 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEANNA VELAZQUEZ Owner, Clinical Director 704-968-2492 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Additional Taxonomies | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children |
| Enumeration Date | 2024-11-30 |
| Last Update Date | 2024-12-02 |