| NPI | 1104448711 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA JACKSON Chief Executive Officer 252-364-1854 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YM0800X Counselor, Mental Health | |
| 101YP2500X Counselor, Professional | |
| Enumeration Date | 2020-05-18 |
| Last Update Date | 2020-09-29 |