| NPI | 1003184789 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNETTA C RAINER Owner 910-291-0078 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| 101YM0800X Counselor, Mental Health | |
| 101YP2500X Counselor, Professional | |
| 103TP0016X Psychologist, Prescribing (Medical) | |
| 1041C0700X Social Worker, Clinical | |
| 208D00000X General Practice | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2011-12-08 |
| Last Update Date | 2016-05-20 |