| NPI | 1316138795 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CALVIN LEE TAYLOR Owner/Operator 704-994-9411 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 251B00000X Case Management |
| 305R00000X Preferred Provider Organization | |
| Enumeration Date | 2007-08-09 |
| Last Update Date | 2007-08-09 |