| NPI | 1053553008 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID L. FOGLE Executive Director 704-867-8749 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NC 6106324) |
| Enumeration Date | 2009-04-06 |
| Last Update Date | 2009-06-12 |