| NPI | 1871367961 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW OLIVER CEO 704-335-2760 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2023-11-09 |
| Last Update Date | 2024-05-22 |