| NPI | 1730558016 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VELAR FARMER Owner 704-345-1858 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251C00000X |
| Additional Taxonomies | 261QD1600X Clinic/Center, Developmental Disabilities |
| 261QR0400X Clinic/Center, Rehabilitation | |
| Enumeration Date | 2015-09-17 |
| Last Update Date | 2015-09-17 |