| NPI | 1861778102 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AHMAD BLAKENEY CEO 704-248-0514 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 103TE1100X Psychologist, Exercise & Sports | |
| 1041C0700X Social Worker, Clinical | |
| 251S00000X | |
| Enumeration Date | 2011-11-01 |
| Last Update Date | 2011-11-01 |