| NPI | 1518204601 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHLEY CHANIESE FRANCIS Clinical Team Lead, Counselor Ii 704-778-6141 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: NC 8083A) |
| Enumeration Date | 2013-01-09 |
| Last Update Date | 2013-01-09 |