| NPI | 1568008266 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRAVIS SCOTT BOBB President 704-277-8197 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| 101YM0800X Counselor, Mental Health | |
| 101YP2500X Counselor, Professional | |
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2019-11-18 |
| Last Update Date | 2024-06-14 |