| NPI | 1174465702 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN KEITH STOUDMIRE Medical Director 704-699-5296 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0802X Psychiatry & Neurology, Addiction Psychiatry |
| Enumeration Date | 2026-04-06 |
| Last Update Date | 2026-04-06 |