| NPI | 1962179150 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMELIA GILLER Mental Health Counselor 704-651-5399 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2021-08-25 |
| Last Update Date | 2021-08-25 |