| NPI | 1104355080 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LADONNA WALTERS Director 252-361-4584 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| Enumeration Date | 2017-06-05 |
| Last Update Date | 2022-07-21 |