| NPI | 1699083899 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM BULLOCK President 704-537-1022 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: NC MHL-060-1173) |
| Enumeration Date | 2010-09-22 |
| Last Update Date | 2017-10-26 |