| NPI | 1477058196 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANDRA MALDONADO Billing Manager 704-469-1243 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2018-03-26 |
| Last Update Date | 2026-05-09 |