| NPI | 1205327004 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACEY MICHELLE CRUZ Organizer 704-266-2069 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: NC 9838) |
| Enumeration Date | 2018-05-29 |
| Last Update Date | 2022-05-27 |