| NPI | 1184182891 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KERRY A PAKSOY Owner/Operator 919-670-5972 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2019-03-12 |
| Last Update Date | 2019-03-12 |