| NPI | 1750418273 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD PHILLIP VANDERSHORST Executive Director 704-535-5590 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2007-02-28 |
| Last Update Date | 2020-08-22 |