| NPI | 1053837500 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LILLIE MARIE JACOBS Owner 704-566-9437 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NC C002751) |
| Enumeration Date | 2017-08-16 |
| Last Update Date | 2022-07-21 |