NPI | 1043077290 |
---|---|
Entity Type | Organization |
Authorized Contact | ARTENTUS LASHA WILSON Owner 704-361-1999 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
Additional Taxonomies | 251S00000X |
Enumeration Date | 2024-03-04 |
Last Update Date | 2024-03-04 |