| NPI | 1164963633 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONNA LATIMER Executive Director 252-212-5524 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YM0800X Counselor, Mental Health | |
| 1041C0700X Social Worker, Clinical | |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| 261QM1300X Clinic/Center, Multi-Specialty (Licence: NC MHL-064-150) | |
| Enumeration Date | 2017-03-16 |
| Last Update Date | 2020-01-21 |