| NPI | 1326249434 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORETTA I TILLMAN Executive Clinical Director 704-921-6777 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: NC 3411) |
| Enumeration Date | 2007-05-29 |
| Last Update Date | 2020-08-22 |