| NPI | 1144840760 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAUREN LEAK HARPER LEAK Owner/Operator 704-402-4268 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| 175T00000X Peer Specialist | |
| Enumeration Date | 2020-04-23 |
| Last Update Date | 2020-04-23 |