| NPI | 1609320332 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SALLY IRONSIDE HAYNES Owner 704-762-7400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2016-08-10 |
| Last Update Date | 2024-04-03 |