| NPI | 1215211313 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LA TOYA PETERSEN CEO 704-273-6238 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 103TC2200X Psychologist, Clinical Child & Adolescent | |
| 1041C0700X Social Worker, Clinical | |
| Enumeration Date | 2011-10-06 |
| Last Update Date | 2012-09-10 |