| NPI | 1104063551 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY ELIZABETH PORRAS KANTROWITZ Accounts Receivable 704-536-0375 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2009-01-07 |
| Last Update Date | 2017-11-09 |