| NPI | 1568999654 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADRIAN FABRIKANT Clinical Director 704-680-6490 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NC 11361) |
| Enumeration Date | 2017-05-19 |
| Last Update Date | 2017-05-19 |