| NPI | 1154006104 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA QUEEN Business Manager 704-975-0691 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| 251S00000X Community/Behavioral Health | |
| 261QM0850X Clinic/Center Adult Mental Health | |
| 261QM0855X Clinic/Center Adolescent and Children Mental Health | |
| Enumeration Date | 2023-06-19 |
| Last Update Date | 2023-06-21 |