| NPI | 1922778133 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEROME ARNESS JOHNSON Manager 704-685-2979 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2021-09-18 |
| Last Update Date | 2021-09-18 |