| NPI | 1467525873 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEMETRIUS CRAYTON Ed 704-956-3062 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| 1041C0700X Social Worker, Clinical | |
| Enumeration Date | 2006-11-15 |
| Last Update Date | 2017-03-08 |