| NPI | 1003108200 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VANDE WILSON Director 910-299-0848 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NC 7604) |
| 101Y00000X Counselor | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 2064) | |
| 251S00000X | |
| Enumeration Date | 2011-05-05 |
| Last Update Date | 2015-07-21 |