| NPI | 1548796766 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMARR FUNDERBURG Owner 704-771-4633 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: SC 10648) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: SC 10648) |
| Enumeration Date | 2017-05-08 |
| Last Update Date | 2021-12-13 |