| NPI | 1578851093 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES EARL LEE Owner 704-749-3808 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NC 163529) |
| Enumeration Date | 2011-07-18 |
| Last Update Date | 2011-07-18 |