| NPI | 1871809764 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SIMONA YVONNE MITCHELL Executive Director 704-724-9995 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: LA 10067123#N8E52) |
| Enumeration Date | 2010-08-30 |
| Last Update Date | 2010-08-30 |