| NPI | 1063599843 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARRISSE SOMME COO 704-405-4580 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 174400000X Specialist |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2024-02-28 |