| NPI | 1770884215 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA NICOLE DOCKERY Credentialing Supervisor 828-837-0071 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 251B00000X Case Management | |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| Enumeration Date | 2010-11-16 |
| Last Update Date | 2018-11-01 |