| NPI | 1093160178 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DORENZO HUDSON Manager 704-904-8684 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225XM0800X Occupational Therapist, Mental Health |
| Additional Taxonomies | 251B00000X Case Management |
| 251E00000X Home Health | |
| 251S00000X | |
| 252Y00000X Early Intervention Provider Agency | |
| 253Z00000X In Home Supportive Care | |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| 385HR2055X Respite Care, Respite Care, Mental Illness, Child | |
| Enumeration Date | 2016-04-26 |
| Last Update Date | 2016-04-26 |