| NPI | 1730365941 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACY NICKOL CONNOR-RIDDICK CEO 704-724-4815 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2008-01-17 |
| Last Update Date | 2008-01-17 |