| NPI | 1902487614 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CATHERINE HARRISON Contracts Specialist 704-362-6759 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2021-04-15 |
| Last Update Date | 2022-03-29 |