| NPI | 1063868891 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FASHENDA LITTLE GERALD Operations Manager 704-289-3831 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2016-05-11 |
| Last Update Date | 2021-02-20 |