| NPI | 1184809808 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAVONDELL RISOTTO STALLINGS Executive Director 336-378-0109 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 291U00000X Clinical Medical Laboratory |
| Enumeration Date | 2007-12-31 |
| Last Update Date | 2015-10-15 |