| NPI | 1164665790 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EBONIQUE MORMAN Administrative Director 704-665-7499 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2009-04-13 |
| Last Update Date | 2022-03-24 |