| NPI | 1114123635 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WANDA WILLIAMS Director 252-758-2065 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NC MHL074155) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC MHL074155) |
| 101YM0800X Counselor, Mental Health (Licence: NC MH074115) | |
| 103TC0700X Psychologist, Clinical (Licence: NC MHL074155) | |
| 1041C0700X Social Worker, Clinical (Licence: NC MHL074155) | |
| Enumeration Date | 2007-06-22 |
| Last Update Date | 2009-06-08 |