NPI | 1013105709 |
---|---|
Entity Type | Organization |
Authorized Contact | EBONIQUE MORMAN Administrative Director 704-784-0753 |
Organization Subpart ? | No |
Primary Taxonomy | 251S00000X |
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 |