| NPI | 1649552332 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY GWEN HALES Clinical Therapist 704-587-5469 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NC 1701) |
| Enumeration Date | 2011-09-19 |
| Last Update Date | 2011-09-19 |