| NPI | 1033413109 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OCTAVIA DEVONNE SHANKLE President/ Director 704-361-5395 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2011-01-05 |
| Last Update Date | 2011-01-05 |