| NPI | 1164118543 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACQUELINE PARKS LEACH Therapist 704-418-1632 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2023-04-18 |
| Last Update Date | 2023-04-18 |