| NPI | 1831861632 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELNITA TOTARSHA OTTEY Owner 704-635-4985 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2021-09-30 |
| Last Update Date | 2023-02-15 |