| NPI | 1912023706 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN EDWARD KOPPELMEYER President 704-872-4157 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NC MHL049090) |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2009-10-21 |