| NPI | 1134501836 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRYSTAL LASHON SMITH Licensed Clinical Social Worker 919-332-4043 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: MD 15128) |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health (Licence: MD 15128) |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: MD 15128) | |
| Enumeration Date | 2015-06-18 |
| Last Update Date | 2015-06-18 |