| NPI | 1962734954 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HERB GRAY CEO 704-560-4332 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: TX 19312) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: TX 19312) |
| 101YM0800X Counselor Mental Health (Licence: TX 19312) | |
| 101YP2500X Counselor Professional (Licence: TX 19312) | |
| 101YS0200X Counselor School (Licence: TX 19312) | |
| 106H00000X Marriage & Family Therapist (Licence: TX 19312) | |
| 251S00000X Community/Behavioral Health | |
| Enumeration Date | 2010-02-02 |
| Last Update Date | 2010-12-01 |