| NPI | 1447798640 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LILY MUDRY Owner 704-750-1007 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NC S7638) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: NC 7638) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 1717) | |
| Enumeration Date | 2017-02-08 |
| Last Update Date | 2017-02-08 |