| NPI | 1770811143 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LILLENE NATHAN Owner 704-820-6501 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NC 830226) |
| Enumeration Date | 2009-11-24 |
| Last Update Date | 2009-11-24 |