| NPI | 1659745909 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM BURRELL CRITTENDON Manager 704-969-4182 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2015-11-24 |
| Last Update Date | 2018-07-30 |