| NPI | 1811475569 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTHONY T HINES Secretary/Lpc 571-330-2829 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: NC A-13289) |
| Enumeration Date | 2018-08-04 |
| Last Update Date | 2018-08-04 |