| NPI | 1134409618 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HEATHER TAVELLA Director/Owner/Counselor 704-880-4003 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NC 7986) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 1682) |
| Enumeration Date | 2011-08-28 |
| Last Update Date | 2012-02-01 |