| NPI | 1053149476 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TREVOR AARON ULRICH Owner 919-341-7503 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0401X Family Medicine Addiction Medicine |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| Enumeration Date | 2024-07-25 |
| Last Update Date | 2025-08-15 |