| NPI | 1104384445 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARECIUS SAMUEL CEO/Mental Health Clinician 919-559-5568 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| Enumeration Date | 2019-03-06 |
| Last Update Date | 2019-03-06 |