NPI 1215061007

Youth Adult Care Management

Organisation Emotionally Disturbed Childrens' Residential Treatment Facility Kannapolis, NC

Practice location

Address: 730 Jack St, Kannapolis, NC 28081-9573
Phone: (704) 933-3505
Mailing address: PO Box 1013, Concord, NC 28026-1013

Authorised official

Name: Chon Black
Title: Director
Phone: (704) 933-3505

Registered specialties

Emotionally Disturbed Childrens' Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 322D00000X Licence MHL-080-121 (NC)

Other Residential Treatment Facility, Emotionally Disturbed Children providers in North Carolina →

Registry record

NPI: 1215061007
Entity type: Organization
NPI issued: 15 Mar 2007
Record last updated: 1 Aug 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.