| NPI | 1811040264 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WINSTON LASSITER Excutive Director 704-563-9908 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NC MHL-060-257) |
| Enumeration Date | 2007-01-19 |
| Last Update Date | 2020-08-22 |