| NPI | 1174672802 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA DENISE BAKER Director 336-884-8658 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: NC 3681) |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2007-01-10 |
| Last Update Date | 2022-06-28 |