| NPI | 1104250919 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY L SMITH Chief Executive Officer 704-819-6212 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| 101YM0800X Counselor, Mental Health | |
| 103T00000X Psychologist | |
| 103TB0200X Psychologist, Cognitive & Behavioral | |
| 103TC0700X Psychologist, Clinical | |
| 103TF0200X Psychologist, Forensic | |
| 103TH0004X Psychologist, Health | |
| 103TM1800X Psychologist, Intellectual & Developmental Disabilities | |
| 103TP2701X Psychologist, Group Psychotherapy | |
| 1041C0700X Social Worker, Clinical | |
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2013-08-28 |
| Last Update Date | 2013-10-15 |