| NPI | 1447957568 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICHOLE C LENTZ Counselor 704-902-4362 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2023-02-09 |
| Last Update Date | 2023-02-09 |