| NPI | 1649533456 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN EDWARD LATZ Member/Manager 704-662-3270 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: NC 182937) |
| Enumeration Date | 2012-06-18 |
| Last Update Date | 2012-06-18 |