| NPI | 1992982474 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HEATHER LESLIE FORTE Owner 704-706-4528 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NC C005323) |
| Enumeration Date | 2008-01-27 |
| Last Update Date | 2014-08-29 |