| NPI | 1306376660 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAKIERRA LANAE HOPKINS Owner 704-719-0832 |
| Organization Subpart ? | No |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2017-06-19 |
| Last Update Date | 2022-07-21 |