| NPI | 1366080921 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANA RENEE CHAMBERS Owner 704-953-5691 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2019-12-13 |
| Last Update Date | 2019-12-13 |