| NPI | 1568668333 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COLETTA LASHEA HEADEN Director 704-968-1864 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: 1915991) |
| Enumeration Date | 2007-06-26 |
| Last Update Date | 2020-08-22 |