| NPI | 1063296689 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMARIA WELCH Owner 336-908-2333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 251S00000X Community/Behavioral Health | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2023-08-23 |
| Last Update Date | 2026-05-22 |