| NPI | 1093727893 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELVIN FERNANDEZ HALL President 704-852-3778 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251B00000X Case Management |
| Additional Taxonomies | 103TP0016X Psychologist, Prescribing (Medical) (Licence: NC 9401389) |
| Enumeration Date | 2006-08-12 |
| Last Update Date | 2011-06-29 |