| NPI | 1225187180 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVIE WIDEMAN Owner 704-640-5501 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101Y00000X Counselor |
| 1041C0700X Social Worker, Clinical | |
| 207R00000X Internal Medicine | |
| 2084A0401X Psychiatry & Neurology, Addiction Medicine | |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| 208D00000X General Practice | |
| 251B00000X Case Management | |
| 253J00000X Foster Care Agency | |
| 253Z00000X In Home Supportive Care | |
| 291U00000X Clinical Medical Laboratory | |
| 363A00000X Physician Assistant | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| 364S00000X Clinical Nurse Specialist | |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2021-09-28 |