| NPI | 1316344542 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY LUCAS LACEY Counselor 704-421-5505 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NC LPC3459) |
| Enumeration Date | 2014-12-03 |
| Last Update Date | 2014-12-03 |