| NPI | 1902487473 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOAN DONETTE CLARK Director/Owner 704-712-1195 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2021-04-16 |
| Last Update Date | 2024-03-24 |