| NPI | 1508165986 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY MASSEY Program Director 704-712-6998 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251B00000X Case Management |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent |
| 103TP2701X Psychologist, Group Psychotherapy | |
| 251K00000X Public Health or Welfare | |
| 251S00000X | |
| 252Y00000X Early Intervention Provider Agency | |
| 253Z00000X In Home Supportive Care | |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| 347C00000X Private Vehicle | |
| Enumeration Date | 2011-03-24 |
| Last Update Date | 2011-03-24 |