| NPI | 1063812642 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICKIE SMITH YELVERTON Executive Program Director 919-961-5123 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2014-09-02 |
| Last Update Date | 2014-09-02 |