| NPI | 1043085269 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRENTON SCOVELL Chief Operating Officer 704-443-8277 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2023-11-17 |
| Last Update Date | 2023-11-17 |