| NPI | 1841866068 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRASHA J BLACK Executive Director 704-596-0505 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QC1500X Clinic/Center, Community Health |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 251B00000X Case Management | |
| 251C00000X | |
| 251S00000X Community/Behavioral Health | |
| 251V00000X Voluntary or Charitable | |
| 261Q00000X | |
| 261QF0050X Clinic/Center, Family Planning, Non-Surgical | |
| 261QH0100X Clinic/Center, Health Services | |
| 261QM0801X | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| 261QP2300X Clinic/Center, Primary Care | |
| 261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) | |
| 261QR1300X Clinic/Center, Rural Health | |
| 261QU0200X Clinic/Center, Urgent Care | |
| Enumeration Date | 2021-05-28 |
| Last Update Date | 2021-05-28 |