Organization
RADIANT RETREAT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VIVIAN EULADEAN CLARK (OWNER)
(704) 208-1887
Entity
Organization
Contact information
Practice address
7466 BOULAIDE ST SW, CONCORD, NC 28025-6219
(704) 208-1887
Mailing address
7466 BOULAIDE ST SW, CONCORD, NC 28025-6219
(704) 208-1887
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
02/06/2026
Last updated
02/14/2026
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