| NPI | 1629311063 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH ADEDOKUN CEO 704-732-2006 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: NC NC 93-00472) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: NC 795) |
| 1041C0700X Social Worker Clinical (Licence: NC C002728) | |
| 363L00000X Nurse Practitioner (Licence: NC 5004878) | |
| 363LA2200X Nurse Practitioner Adult Health (Licence: NC 5004910) | |
| Enumeration Date | 2013-04-04 |
| Last Update Date | 2013-04-04 |