| NPI | 1407585706 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEREMY FITZGERALD Intensive In Home Therapist 704-565-9538 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2022-06-10 |
| Last Update Date | 2022-06-10 |