| NPI | 1205459682 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TENISHA ROSS Msw, Lcsw,Lcas A/Owner 704-476-9016 |
| Organization Subpart ? | No |
| Primary Taxonomy | 104100000X Social Worker |
| Additional Taxonomies | 1041C0700X Social Worker Clinical |
| 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) | |
| 261QM0850X Clinic/Center Adult Mental Health | |
| 261QM0855X Clinic/Center Adolescent and Children Mental Health | |
| Enumeration Date | 2020-05-20 |
| Last Update Date | 2022-09-06 |