| NPI | 1588956403 |
|---|---|
| Other Name | CLYDE MSG |
| Entity Type | Organization |
| Authorized Contact | JOHN KOPPELMEYER President/CEO 704-872-4157 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2011-05-11 |
| Last Update Date | 2011-05-11 |