| NPI | 1073154514 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACEY ANN BROWN Contracts Administrator 336-889-6105 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YP2500X Counselor, Professional | |
| 1041C0700X Social Worker, Clinical | |
| 251S00000X | |
| 363L00000X Nurse Practitioner | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2019-10-07 |
| Last Update Date | 2024-05-20 |