NPI | 1861159634 |
---|---|
Entity Type | Organization |
Authorized Contact | LAURIE TROSUK Sole Proprietor 704-813-9102 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
Enumeration Date | 2021-11-29 |
Last Update Date | 2021-11-29 |