| NPI | 1134443351 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM JEFFERY MASSEY CEO 704-225-0584 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: NC 5212) |
| Additional Taxonomies | 261Q00000X Clinic/Center (Licence: NC 5901922) |
| Enumeration Date | 2010-03-17 |
| Last Update Date | 2011-05-12 |