| NPI | 1194019109 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AHMAD BLAKENEY CEO 704-287-1573 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YP2500X Counselor, Professional | |
| 1041C0700X Social Worker, Clinical | |
| Enumeration Date | 2011-06-07 |
| Last Update Date | 2011-06-07 |