| NPI | 1881125219 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NYREE DAWN GLEAVES CEO 704-222-1399 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: AZ CSLG8170) |
| Enumeration Date | 2017-03-27 |
| Last Update Date | 2017-03-27 |