| NPI | 1619285756 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH ADEDOKUN Director/CEO 704-405-1617 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: NC NC 2005-00391) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: NC 795) |
| 101YP2500X Counselor Professional (Licence: NC 5171) | |
| 1041C0700X Social Worker Clinical (Licence: NC C001664) | |
| 363LA2200X Nurse Practitioner Adult Health (Licence: NC 0600071) | |
| Enumeration Date | 2010-09-23 |
| Last Update Date | 2010-09-23 |