| NPI | 1154043396 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERWIN KELLY Executive Director 910-261-1085 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 101YP2500X Counselor, Professional | |
| 1041C0700X Social Worker, Clinical | |
| Enumeration Date | 2022-09-14 |
| Last Update Date | 2024-05-15 |