| NPI | 1184200545 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENDA KELLY CEO 336-963-3093 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QC1500X Clinic/Center, Community Health |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 174200000X | |
| 251B00000X Case Management | |
| 251S00000X | |
| 251V00000X Voluntary or Charitable | |
| 261QH0100X Clinic/Center, Health Services | |
| 291U00000X Clinical Medical Laboratory | |
| Enumeration Date | 2021-03-24 |
| Last Update Date | 2022-12-04 |