| NPI | 1184457475 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | LADONNA CLARK Program Manager 919-306-0809 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health | 
| Enumeration Date | 2024-08-22 | 
| Last Update Date | 2024-08-22 |