Organization
MURRAY ADOLESCENT TRAINING &TX ACADEMY
Active
Other names
Peaceful Dominion Group Home
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CYNTHIA S MURRAY (VICE PRESIDENT)
(704) 372-4915
Entity
Organization
Contact information
Practice address
2012 COMMONWEALTH AVE, CHARLOTTE, NC 28205-5022
(704) 372-4915
(704) 372-4917
Mailing address
2012 COMMONWEALTH AVE, CHARLOTTE, NC 28205-5022
(704) 372-4915
(704) 372-4917
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
065181
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6603795
—
NC
Enumeration date
04/03/2007
Last updated
08/22/2020
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