| NPI | 1770895310 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIRBY NICKERSON CFO 704-637-2870 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Additional Taxonomies | 103TC1900X Psychologist, Counseling |
| 103TH0100X Psychologist, Health Service | |
| 103TP0016X Psychologist, Prescribing (Medical) | |
| 103TP0814X Psychologist, Psychoanalysis | |
| 253J00000X Foster Care Agency | |
| 322D00000X Residential Treatment Facility, Emotionally Disturbed Children | |
| Enumeration Date | 2010-07-12 |
| Last Update Date | 2013-08-23 |