| NPI | 1699086009 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DERRICK WHISEL President 704-287-2081 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: SC 5065) |
| Enumeration Date | 2010-06-30 |
| Last Update Date | 2010-06-30 |