| NPI | 1164169132 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARUKA J RIVERS Owner/Senior Clinical Director 336-456-3576 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2022-05-19 |
| Last Update Date | 2022-05-19 |