| NPI | 1962705418 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENDELL JASPER Clinical Director 704-910-5395 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 251B00000X Case Management |
| Enumeration Date | 2010-12-06 |
| Last Update Date | 2019-05-14 |