| NPI | 1396282661 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAMERON GARRISON Clinical Social Worker 704-860-7909 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: NC C0100066) |
| Enumeration Date | 2017-01-25 |
| Last Update Date | 2017-01-25 |