| NPI | 1659782449 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELLY PERDUE Clinical Supervisor 704-871-0934 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NC A10769) |
| Enumeration Date | 2014-05-14 |
| Last Update Date | 2014-05-14 |