| NPI | 1528723582 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERICA BLACK Owner/Director 704-512-8166 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2021-11-04 |
| Last Update Date | 2022-03-07 |