| NPI | 1093958639 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES HENRY COHEN Member 704-851-9881 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NC C200906200174) |
| Enumeration Date | 2009-04-13 |
| Last Update Date | 2009-04-13 |