| NPI | 1902179294 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRAIG BASS CEO 704-366-8712 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2012-02-16 |
| Last Update Date | 2015-06-10 |