Organization
LIFE CHALLENGES ADOLESCENT TRAINING & TREATMENT ACADEMY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. OCTAVIA DEVONNE SHANKLE (EXECUTIVE DIRECTOR)
(704) 739-2764
Entity
Organization
Contact information
Practice address
1127 BETHLEHEM RD, KINGS MOUNTAIN, NC 28086-8280
(704) 739-2764
(704) 734-1107
Mailing address
1127 BETHLEHEM RD, KINGS MOUNTAIN, NC 28086-8280
(704) 739-2764
(704) 734-1107
Taxonomy
Speciality
Code
Description
License number
State
3245S0500X
Children's Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
04/30/2009
Last updated
04/30/2009
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