| NPI | 1124243209 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES LUTHER BURSTON Owner Administrator 336-613-5515 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 103TC0700X Psychologist, Clinical | |
| Enumeration Date | 2007-04-16 |
| Last Update Date | 2020-08-22 |