| NPI | 1114791423 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEFANIE M. LAWSON Owner 336-916-1584 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2023-11-08 |
| Last Update Date | 2023-11-08 |