| NPI | 1588536858 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNON L ANES Member/Organizer 704-312-0496 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2025-09-18 |
| Last Update Date | 2025-09-18 |