| NPI | 1235802125 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAREN JEAN BRYANT Owner 704-806-8307 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2021-07-27 |
| Last Update Date | 2023-11-28 |