| NPI | 1124675673 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HEIDI YVETTE HERRING Executive Director 910-640-1830 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| 101YM0800X Counselor Mental Health | |
| 1041C0700X Social Worker Clinical | |
| 207R00000X Internal Medicine | |
| 363A00000X Physician Assistant | |
| 363LP0808X Nurse Practitioner Psychiatric/Mental Health | |
| Enumeration Date | 2019-08-20 |
| Last Update Date | 2019-08-20 |