| NPI | 1275603433 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GRAYCE CROCKETT Area Director 704-336-8638 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2020-08-22 |