| NPI | 1629630876 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MONIQUE HEATH Clinical Director 704-612-0180 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 101YA0400X Counselor Addiction (Substance Use Disorder) | |
| Enumeration Date | 2019-07-08 |
| Last Update Date | 2019-07-08 |