| NPI | 1013105709 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EBONIQUE MORMAN Administrative Director 704-784-0753 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2007-10-09 |
| Last Update Date | 2022-07-21 |