| NPI | 1003248808 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN KEITH STOUDMIRE President 704-699-5296 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NC 200500827) |
| Enumeration Date | 2013-08-02 |
| Last Update Date | 2013-08-05 |