| NPI | 1740945245 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY RUSHING Licensed Clinical Social Worker 704-231-5299 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2021-11-01 |
| Last Update Date | 2025-02-18 |