| NPI | 1467720565 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COLLEEN MARY SERRENO Owner 704-892-1828 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: NC 3977) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: NC 1132) |
| Enumeration Date | 2011-12-05 |
| Last Update Date | 2011-12-05 |