| NPI | 1619203767 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRYSTAL MCNIEL Owner 704-641-4515 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NC C5084) |
| Enumeration Date | 2009-10-25 |
| Last Update Date | 2009-10-25 |