| NPI | 1104487107 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA LAVERNE KING Owner 919-669-0004 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2019-06-21 |
| Last Update Date | 2019-06-21 |