| NPI | 1578133781 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE FOSTER GASKINS Director/Clinician 704-931-1010 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 310500000X Intermediate Care Facility, Mental Illness |
| Enumeration Date | 2021-06-29 |
| Last Update Date | 2022-05-09 |