| NPI | 1467782177 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMARR J FUNDERBURG Owner/Therapist 704-771-4633 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Additional Taxonomies | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 1184) | |
| 101YM0800X Counselor, Mental Health (Licence: NC C005599) | |
| 103K00000X Behavior Analyst (Licence: NC C005599) | |
| 1041C0700X Social Worker, Clinical (Licence: NC C005599) | |
| 251S00000X (Licence: NC C005599) | |
| Enumeration Date | 2009-12-31 |
| Last Update Date | 2024-02-26 |