| NPI | 1801686209 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELAINE JACKSON Owner 704-710-6220 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2025-05-08 |
| Last Update Date | 2025-05-08 |