| NPI | 1407391246 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRYSTAL BAILEY Owner 704-762-0074 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 3447) |
| 101YM0800X Counselor, Mental Health (Licence: NC 10622) | |
| Enumeration Date | 2017-01-04 |
| Last Update Date | 2018-07-19 |