| NPI | 1801471347 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN M LEDOUX Executive Director 704-604-3515 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2021-03-16 |
| Last Update Date | 2021-03-16 |