| NPI | 1487991279 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY C BRANNON Credentialing 704-884-2060 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NC P007856) |
| Enumeration Date | 2013-01-14 |
| Last Update Date | 2013-01-14 |