| NPI | 1104648005 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAILAH FAGGART Owner 704-305-9703 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174200000X Meals |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 251B00000X Case Management | |
| 251S00000X | |
| 261QA0600X Clinic/Center, Adult Day Care | |
| Enumeration Date | 2024-10-30 |
| Last Update Date | 2024-10-30 |