| NPI | 1174392609 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAUNTE' JOHNSON Owner 336-451-7739 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2023-12-26 |
| Last Update Date | 2023-12-26 |