| NPI | 1598907123 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LILLIAN ROACH Admin 704-536-8381 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NC 6005982) |
| Enumeration Date | 2009-03-27 |
| Last Update Date | 2009-03-27 |