| NPI | 1245970524 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEMETRIUS CRAYTON Executive Director 704-956-3062 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QC1500X Clinic/Center, Community Health |
| Enumeration Date | 2022-04-01 |
| Last Update Date | 2022-04-01 |