| NPI | 1205068228 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMUEL MATTHEW EVANS Owner 704-293-4780 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NC 171324) |
| Enumeration Date | 2009-08-11 |
| Last Update Date | 2009-08-11 |