| NPI | 1992122113 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WAYNE LEVONNE BURCH CFO 704-345-2032 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YM0800X Counselor, Mental Health | |
| 1041C0700X Social Worker, Clinical | |
| 251S00000X | |
| Enumeration Date | 2014-03-26 |
| Last Update Date | 2014-12-01 |