| NPI | 1346934288 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEON DEVONTE BREEDEN Director 704-386-8651 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2023-06-05 |
| Last Update Date | 2023-06-05 |