| NPI | 1134651623 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NYREE GLEAVES CEO 704-222-1399 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: AZ CSLG8170) |
| Enumeration Date | 2017-04-03 |
| Last Update Date | 2017-04-03 |