| NPI | 1245625193 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VENITA CATRICE RANDALL Mental Health Clinical Counselor 704-561-1913 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2015-03-30 |
| Last Update Date | 2016-01-06 |