| NPI | 1780033233 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARYANN CATHERINE RICHARDSON Director 704-910-6142 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Additional Taxonomies | 251B00000X Case Management (Licence: NC 5004974) |
| 261QM0850X Clinic/Center Adult Mental Health (Licence: NC 5004974) | |
| 261QM0855X Clinic/Center Adolescent and Children Mental Health (Licence: NC 5004974) | |
| 261QP2300X Clinic/Center Primary Care (Licence: NC 5004974) | |
| Enumeration Date | 2016-06-06 |
| Last Update Date | 2024-01-26 |