| NPI | 1700390093 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JATANA SMITH Operations Director 704-578-4845 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2017-11-22 |
| Last Update Date | 2025-09-11 |